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 $114.82 Typical High $141.25 | Facility | None | $100.00 | $114.82 | $141.25 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $114.82 Typical High $131.83 | Professional | None | $102.33 | $114.82 | $131.83 |
Ambetter Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | None | $154.88 | $154.88 | $154.88 |
BCBS Arkansas Setting Facility Modifier None Typical Low $1,584.89 Median $2,884.03 Typical High $3,981.07 | Facility | None | $1,584.89 | $2,884.03 | $3,981.07 |
BCBS Arkansas Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $131.83 | Professional | None | $100.00 | $100.00 | $131.83 |
Cigna Setting Facility Modifier None Typical Low $380.19 Median $1,584.89 Typical High $1,949.84 | Facility | None | $380.19 | $1,584.89 | $1,949.84 |
Cigna Setting Professional Modifier None Typical Low $95.50 Median $162.18 Typical High $181.97 | Professional | None | $95.50 | $162.18 | $181.97 |
Qualchoice Setting Professional Modifier None Typical Low $165.96 Median $177.83 Typical High $177.83 | Professional | None | $165.96 | $177.83 | $177.83 |
United Setting Facility Modifier None Typical Low $794.33 Median $1,148.15 Typical High $3,388.44 | Facility | None | $794.33 | $1,148.15 | $3,388.44 |
United Setting Professional Modifier None Typical Low $91.20 Median $109.65 Typical High $190.55 | Professional | None | $91.20 | $109.65 | $190.55 |
4 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 $56.23 Median $57.54 Typical High $57.54 | Professional | 52 · Reduced service | $56.23 | $57.54 | $57.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $22.91 Typical High $22.91 | Professional | 53 · Discontinued | $22.39 | $22.91 | $22.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $17.38 Typical High $17.38 | Professional | 55 · Aftercare only | $16.98 | $17.38 | $17.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $11.48 Typical High $11.48 | Professional | 56 · Pre-op care only | $11.22 | $11.48 | $11.48 |
Where Arkansas sits
The same service costs 7.9 times more in Kansas 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· 2nd of 51
$794
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.