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 $144.54 Median $1,000.00 Typical High $2,041.74 | Facility | None | $144.54 | $1,000.00 | $2,041.74 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $177.83 Typical High $213.80 | Professional | None | $144.54 | $177.83 | $213.80 |
Ambetter Setting Professional Modifier None Typical Low $245.47 Median $263.03 Typical High $263.03 | Professional | None | $245.47 | $263.03 | $263.03 |
BCBS Arkansas Setting Facility Modifier None Typical Low $95.50 Median $707.95 Typical High $977.24 | Facility | None | $95.50 | $707.95 | $977.24 |
BCBS Arkansas Setting Professional Modifier None Typical Low $123.03 Median $162.18 Typical High $234.42 | Professional | None | $123.03 | $162.18 | $234.42 |
Cigna Setting Facility Modifier None Typical Low $87.10 Median $104.71 Typical High $512.86 | Facility | None | $87.10 | $104.71 | $512.86 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $218.78 Typical High $281.84 | Professional | None | $131.83 | $218.78 | $281.84 |
Qualchoice Setting Professional Modifier None Typical Low $281.84 Median $302.00 Typical High $302.00 | Professional | None | $281.84 | $302.00 | $302.00 |
United Setting Facility Modifier None Typical Low $269.15 Median $389.05 Typical High $1,548.82 | Facility | None | $269.15 | $389.05 | $1,548.82 |
United Setting Professional Modifier None Typical Low $114.82 Median $162.18 Typical High $302.00 | Professional | None | $114.82 | $162.18 | $302.00 |
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 $72.44 Median $87.10 Typical High $95.50 | Professional | 52 · Reduced service | $72.44 | $87.10 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $34.67 Typical High $38.02 | Professional | 53 · Discontinued | $28.84 | $34.67 | $38.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $128.82 Typical High $141.25 | Professional | 54 · Surgery only | $107.15 | $128.82 | $141.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $25.70 Typical High $28.18 | Professional | 55 · Aftercare only | $21.38 | $25.70 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $17.38 Typical High $19.05 | Professional | 56 · Pre-op care only | $14.45 | $17.38 | $19.05 |
Where Arkansas sits
The same service costs 3.7 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
$219
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.