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 $54.95 Median $1,174.90 Typical High $2,454.71 | Facility | None | $54.95 | $1,174.90 | $2,454.71 |
Aetna Setting Professional Modifier None Typical Low $54.95 Median $75.86 Typical High $97.72 | Professional | None | $54.95 | $75.86 | $97.72 |
Ambetter Setting Professional Modifier None Typical Low $102.33 Median $109.65 Typical High $120.23 | Professional | None | $102.33 | $109.65 | $120.23 |
BCBS Arkansas Setting Facility Modifier None Typical Low $39.81 Median $181.97 Typical High $245.47 | Facility | None | $39.81 | $181.97 | $245.47 |
BCBS Arkansas Setting Professional Modifier None Typical Low $45.71 Median $60.26 Typical High $97.72 | Professional | None | $45.71 | $60.26 | $97.72 |
Cigna Setting Facility Modifier None Typical Low $31.62 Median $34.67 Typical High $107.15 | Facility | None | $31.62 | $34.67 | $107.15 |
Cigna Setting Professional Modifier None Typical Low $54.95 Median $83.18 Typical High $120.23 | Professional | None | $54.95 | $83.18 | $120.23 |
Qualchoice Setting Professional Modifier None Typical Low $100.00 Median $117.49 Typical High $138.04 | Professional | None | $100.00 | $117.49 | $138.04 |
United Setting Facility Modifier None Typical Low $79.43 Median $131.83 Typical High $707.95 | Facility | None | $79.43 | $131.83 | $707.95 |
United Setting Professional Modifier None Typical Low $44.67 Median $70.79 Typical High $125.89 | Professional | None | $44.67 | $70.79 | $125.89 |
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 $27.54 Median $32.36 Typical High $42.66 | Professional | 52 · Reduced service | $27.54 | $32.36 | $42.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $13.18 Typical High $17.38 | Professional | 53 · Discontinued | $10.96 | $13.18 | $17.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $40.74 Median $48.98 Typical High $64.57 | Professional | 54 · Surgery only | $40.74 | $48.98 | $64.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $9.77 Typical High $12.88 | Professional | 55 · Aftercare only | $8.13 | $9.77 | $12.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $6.46 Typical High $8.51 | Professional | 56 · Pre-op care only | $5.50 | $6.46 | $8.51 |
Where Arkansas sits
The same service costs 3.1 times more in Wisconsin than in Washington, DC. 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· 23rd of 51
$85.11
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.