How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $77.62 Median $1,000.00 Typical High $2,041.74 | Facility | None | $77.62 | $1,000.00 | $2,041.74 |
Aetna Setting Professional Modifier None Typical Low $77.62 Median $97.72 Typical High $114.82 | Professional | None | $77.62 | $97.72 | $114.82 |
Ambetter Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $93.33 | Professional | None | $93.33 | $93.33 | $93.33 |
BCBS Arkansas Setting Facility Modifier None Typical Low $57.54 Median $707.95 Typical High $977.24 | Facility | None | $57.54 | $707.95 | $977.24 |
BCBS Arkansas Setting Professional Modifier None Typical Low $66.07 Median $87.10 Typical High $138.04 | Professional | None | $66.07 | $87.10 | $138.04 |
Cigna Setting Facility Modifier None Typical Low $53.70 Median $64.57 Typical High $512.86 | Facility | None | $53.70 | $64.57 | $512.86 |
Cigna Setting Professional Modifier None Typical Low $75.86 Median $117.49 Typical High $158.49 | Professional | None | $75.86 | $117.49 | $158.49 |
Qualchoice Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Professional | None | $107.15 | $107.15 | $107.15 |
United Setting Facility Modifier None Typical Low $269.15 Median $363.08 Typical High $1,548.82 | Facility | None | $269.15 | $363.08 | $1,548.82 |
United Setting Professional Modifier None Typical Low $61.66 Median $89.13 Typical High $165.96 | Professional | None | $61.66 | $89.13 | $165.96 |
5 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $38.90 Median $46.77 Typical High $51.29 | Professional | 52 · Reduced service | $38.90 | $46.77 | $51.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $18.62 Typical High $20.42 | Professional | 53 · Discontinued | $15.49 | $18.62 | $20.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $58.88 Median $69.18 Typical High $75.86 | Professional | 54 · Surgery only | $58.88 | $69.18 | $75.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $13.80 Typical High $15.14 | Professional | 55 · Aftercare only | $11.75 | $13.80 | $15.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $9.33 Typical High $10.23 | Professional | 56 · Pre-op care only | $7.76 | $9.33 | $10.23 |
Where Arkansas sits
The same service costs 3.6 times more in Wisconsin than in Kentucky. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Arkansas· 21st of 51
$117
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.