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 $64.57 Median $1,000.00 Typical High $2,041.74 | Facility | None | $64.57 | $1,000.00 | $2,041.74 |
Aetna Setting Professional Modifier None Typical Low $57.54 Median $64.57 Typical High $70.79 | Professional | None | $57.54 | $64.57 | $70.79 |
BCBS Arkansas Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $81.28 | Professional | None | $61.66 | $61.66 | $81.28 |
Cigna Setting Professional Modifier None Typical Low $52.48 Median $69.18 Typical High $114.82 | Professional | None | $52.48 | $69.18 | $114.82 |
United Setting Facility Modifier None Typical Low $128.82 Median $436.52 Typical High $776.25 | Facility | None | $128.82 | $436.52 | $776.25 |
United Setting Professional Modifier None Typical Low $52.48 Median $69.18 Typical High $125.89 | Professional | None | $52.48 | $69.18 | $125.89 |
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 $28.84 Median $32.36 Typical High $35.48 | Professional | 52 · Reduced service | $28.84 | $32.36 | $35.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $12.88 Typical High $14.13 | Professional | 53 · Discontinued | $11.48 | $12.88 | $14.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $43.65 Median $47.86 Typical High $53.70 | Professional | 54 · Surgery only | $43.65 | $47.86 | $53.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $9.55 Typical High $10.72 | Professional | 55 · Aftercare only | $8.71 | $9.55 | $10.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $6.46 Typical High $7.08 | Professional | 56 · Pre-op care only | $5.75 | $6.46 | $7.08 |
Where Arkansas sits
The same service costs 3.4 times more in Alaska than in Florida. 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· 34th of 51
$69.18
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.