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 $120.23 Median $977.24 Typical High $2,041.74 | Facility | None | $120.23 | $977.24 | $2,041.74 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $154.88 Typical High $186.21 | Professional | None | $114.82 | $154.88 | $186.21 |
Ambetter Setting Professional Modifier None Typical Low $177.83 Median $186.21 Typical High $218.78 | Professional | None | $177.83 | $186.21 | $218.78 |
BCBS Arkansas Setting Facility Modifier None Typical Low $85.11 Median $295.12 Typical High $407.38 | Facility | None | $85.11 | $295.12 | $407.38 |
BCBS Arkansas Setting Professional Modifier None Typical Low $102.33 Median $134.90 Typical High $199.53 | Professional | None | $102.33 | $134.90 | $199.53 |
CareSource Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $177.83 | Professional | None | $177.83 | $177.83 | $177.83 |
Cigna Setting Facility Modifier None Typical Low $72.44 Median $87.10 Typical High $512.86 | Facility | None | $72.44 | $87.10 | $512.86 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $181.97 Typical High $239.88 | Professional | None | $112.20 | $181.97 | $239.88 |
Qualchoice Setting Professional Modifier None Typical Low $204.17 Median $213.80 Typical High $251.19 | Professional | None | $204.17 | $213.80 | $251.19 |
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 $95.50 Median $138.04 Typical High $257.04 | Professional | None | $95.50 | $138.04 | $257.04 |
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 $60.26 Median $70.79 Typical High $79.43 | Professional | 52 · Reduced service | $60.26 | $70.79 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $28.18 Typical High $31.62 | Professional | 53 · Discontinued | $23.99 | $28.18 | $31.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $89.13 Median $107.15 Typical High $120.23 | Professional | 54 · Surgery only | $89.13 | $107.15 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $21.38 Typical High $23.99 | Professional | 55 · Aftercare only | $17.78 | $21.38 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $14.13 Typical High $15.85 | Professional | 56 · Pre-op care only | $12.02 | $14.13 | $15.85 |
Where Arkansas sits
The same service costs 3.2 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· 25th of 51
$166
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.