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 $56.23 Median $1,174.90 Typical High $2,454.71 | Facility | None | $56.23 | $1,174.90 | $2,454.71 |
Aetna Setting Professional Modifier None Typical Low $56.23 Median $72.44 Typical High $87.10 | Professional | None | $56.23 | $72.44 | $87.10 |
Ambetter Setting Professional Modifier None Typical Low $112.20 Median $112.20 Typical High $213.80 | Professional | None | $112.20 | $112.20 | $213.80 |
BCBS Arkansas Setting Facility Modifier None Typical Low $181.97 Median $181.97 Typical High $251.19 | Facility | None | $181.97 | $181.97 | $251.19 |
BCBS Arkansas Setting Professional Modifier None Typical Low $51.29 Median $67.61 Typical High $104.71 | Professional | None | $51.29 | $67.61 | $104.71 |
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 $54.95 Median $97.72 Typical High $147.91 | Professional | None | $54.95 | $97.72 | $147.91 |
Qualchoice Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $245.47 | Professional | None | $128.82 | $128.82 | $245.47 |
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 $47.86 Median $85.11 Typical High $162.18 | Professional | None | $47.86 | $85.11 | $162.18 |
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 $28.18 Median $31.62 Typical High $43.65 | Professional | 52 · Reduced service | $28.18 | $31.62 | $43.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.22 Median $12.59 Typical High $17.38 | Professional | 53 · Discontinued | $11.22 | $12.59 | $17.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $42.66 Median $47.86 Typical High $64.57 | Professional | 54 · Surgery only | $42.66 | $47.86 | $64.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $9.55 Typical High $13.18 | Professional | 55 · Aftercare only | $8.51 | $9.55 | $13.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $6.31 Typical High $8.71 | Professional | 56 · Pre-op care only | $5.62 | $6.31 | $8.71 |
Where Arkansas sits
The same service costs 3.2 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· 26th of 51
$100
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.