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 $63.10 Median $1,000.00 Typical High $2,041.74 | Facility | None | $63.10 | $1,000.00 | $2,041.74 |
Aetna Setting Professional Modifier None Typical Low $58.88 Median $83.18 Typical High $125.89 | Professional | None | $58.88 | $83.18 | $125.89 |
Ambetter Setting Professional Modifier None Typical Low $46.77 Median $93.33 Typical High $151.36 | Professional | None | $46.77 | $93.33 | $151.36 |
BCBS Arkansas Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $144.54 | Professional | None | $109.65 | $109.65 | $144.54 |
CareSource Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $100.00 Typical High $512.86 | Facility | None | $50.12 | $100.00 | $512.86 |
Cigna Setting Professional Modifier None Typical Low $66.07 Median $95.50 Typical High $151.36 | Professional | None | $66.07 | $95.50 | $151.36 |
Qualchoice Setting Professional Modifier None Typical Low $53.70 Median $125.89 Typical High $173.78 | Professional | None | $53.70 | $125.89 | $173.78 |
United Setting Facility Modifier None Typical Low $75.86 Median $128.82 Typical High $707.95 | Facility | None | $75.86 | $128.82 | $707.95 |
United Setting Professional Modifier None Typical Low $50.12 Median $85.11 Typical High $162.18 | Professional | None | $50.12 | $85.11 | $162.18 |
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 $31.62 Median $38.90 Typical High $47.86 | Professional | 52 · Reduced service | $31.62 | $38.90 | $47.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.59 Median $15.49 Typical High $19.05 | Professional | 53 · Discontinued | $12.59 | $15.49 | $19.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $46.77 Median $57.54 Typical High $70.79 | Professional | 54 · Surgery only | $46.77 | $57.54 | $70.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $11.48 Typical High $14.13 | Professional | 55 · Aftercare only | $9.33 | $11.48 | $14.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $7.76 Typical High $9.55 | Professional | 56 · Pre-op care only | $6.31 | $7.76 | $9.55 |
Ambetter Setting Professional Modifier 51 · Multiple procedures Typical Low $33.11 Median $64.57 Typical High $75.86 | Professional | 51 · Multiple procedures | $33.11 | $64.57 | $75.86 |
Qualchoice Setting Professional Modifier 51 · Multiple procedures Typical Low $38.02 Median $45.71 Typical High $87.10 | Professional | 51 · Multiple procedures | $38.02 | $45.71 | $87.10 |
Where Arkansas sits
The same service costs 3.2 times more in Alaska than in New York. 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· 35th of 51
$95.50
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.