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 $100.00 Median $977.24 Typical High $2,041.74 | Facility | None | $100.00 | $977.24 | $2,041.74 |
Aetna Setting Professional Modifier None Typical Low $79.43 Median $114.82 Typical High $141.25 | Professional | None | $79.43 | $114.82 | $141.25 |
Ambetter Setting Professional Modifier None Typical Low $112.20 Median $112.20 Typical High $169.82 | Professional | None | $112.20 | $112.20 | $169.82 |
BCBS Arkansas Setting Facility Modifier None Typical Low $58.88 Median $181.97 Typical High $245.47 | Facility | None | $58.88 | $181.97 | $245.47 |
BCBS Arkansas Setting Professional Modifier None Typical Low $63.10 Median $83.18 Typical High $134.90 | Professional | None | $63.10 | $83.18 | $134.90 |
CareSource Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $117.49 | Professional | None | $117.49 | $117.49 | $117.49 |
Cigna Setting Facility Modifier None Typical Low $44.67 Median $48.98 Typical High $107.15 | Facility | None | $44.67 | $48.98 | $107.15 |
Cigna Setting Professional Modifier None Typical Low $74.13 Median $141.25 Typical High $173.78 | Professional | None | $74.13 | $141.25 | $173.78 |
Qualchoice Setting Professional Modifier None Typical Low $128.82 Median $162.18 Typical High $194.98 | Professional | None | $128.82 | $162.18 | $194.98 |
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 $61.66 Median $100.00 Typical High $177.83 | Professional | None | $61.66 | $100.00 | $177.83 |
7 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 $44.67 Median $50.12 Typical High $61.66 | Professional | 52 · Reduced service | $44.67 | $50.12 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $20.42 Typical High $24.55 | Professional | 53 · Discontinued | $17.78 | $20.42 | $24.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $67.61 Median $75.86 Typical High $93.33 | Professional | 54 · Surgery only | $67.61 | $75.86 | $93.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $15.14 Typical High $18.62 | Professional | 55 · Aftercare only | $13.49 | $15.14 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $10.00 Typical High $12.30 | Professional | 56 · Pre-op care only | $8.91 | $10.00 | $12.30 |
Ambetter Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $128.82 Typical High $144.54 | Professional | 53 · Discontinued | $128.82 | $128.82 | $144.54 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $120.23 Median $141.25 Typical High $141.25 | Professional | 59 · Distinct service | $120.23 | $141.25 | $141.25 |
Where Arkansas sits
The same service costs 3.0 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· 20th of 51
$123
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.