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 $371.54 Median $1,288.25 Typical High $2,454.71 | Facility | None | $371.54 | $1,288.25 | $2,454.71 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $371.54 Typical High $436.52 | Professional | None | $346.74 | $371.54 | $436.52 |
BCBS Arkansas Setting Facility Modifier None Typical Low $2,137.96 Median $4,677.35 Typical High $6,456.54 | Facility | None | $2,137.96 | $4,677.35 | $6,456.54 |
BCBS Arkansas Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $416.87 | Professional | None | $309.03 | $309.03 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $2,089.30 Typical High $2,570.40 | Facility | None | $588.84 | $2,089.30 | $2,570.40 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $562.34 Typical High $630.96 | Professional | None | $229.09 | $562.34 | $630.96 |
United Setting Facility Modifier None Typical Low $1,096.48 Median $1,513.56 Typical High $5,623.41 | Facility | None | $1,096.48 | $1,513.56 | $5,623.41 |
United Setting Professional Modifier None Typical Low $288.40 Median $407.38 Typical High $630.96 | Professional | None | $288.40 | $407.38 | $630.96 |
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 $177.83 Median $186.21 Typical High $194.98 | Professional | 52 · Reduced service | $177.83 | $186.21 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $74.13 Typical High $77.62 | Professional | 53 · Discontinued | $70.79 | $74.13 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $275.42 Typical High $288.40 | Professional | 54 · Surgery only | $263.03 | $275.42 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $54.95 Typical High $57.54 | Professional | 55 · Aftercare only | $52.48 | $54.95 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $37.15 Typical High $38.90 | Professional | 56 · Pre-op care only | $35.48 | $37.15 | $38.90 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $407.38 Median $407.38 Typical High $407.38 | Professional | 59 · Distinct service | $407.38 | $407.38 | $407.38 |
Qualchoice Setting Professional Modifier 59 · Distinct service Typical Low $467.74 Median $467.74 Typical High $467.74 | Professional | 59 · Distinct service | $467.74 | $467.74 | $467.74 |
Where Arkansas sits
The same service costs 10.0 times more in Oklahoma 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· 5th of 51
$1,202
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.