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 $58.88 Typical High $134.90 | Facility | None | $56.23 | $58.88 | $134.90 |
Aetna Setting Professional Modifier None Typical Low $50.12 Median $81.28 Typical High $134.90 | Professional | None | $50.12 | $81.28 | $134.90 |
BCBS Arkansas Setting Facility Modifier None Typical Low $194.98 Median $194.98 Typical High $275.42 | Facility | None | $194.98 | $194.98 | $275.42 |
BCBS Arkansas Setting Professional Modifier None Typical Low $46.77 Median $61.66 Typical High $154.88 | Professional | None | $46.77 | $61.66 | $154.88 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $190.55 Typical High $208.93 | Facility | None | $100.00 | $190.55 | $208.93 |
Cigna Setting Professional Modifier None Typical Low $43.65 Median $95.50 Typical High $173.78 | Professional | None | $43.65 | $95.50 | $173.78 |
United Setting Facility Modifier None Typical Low $281.84 Median $346.74 Typical High $630.96 | Facility | None | $281.84 | $346.74 | $630.96 |
United Setting Professional Modifier None Typical Low $38.90 Median $100.00 Typical High $154.88 | Professional | None | $38.90 | $100.00 | $154.88 |
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 $26.92 Median $40.74 Typical High $67.61 | Professional | 52 · Reduced service | $26.92 | $40.74 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $16.60 Typical High $26.92 | Professional | 53 · Discontinued | $10.96 | $16.60 | $26.92 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $12.30 Typical High $20.42 | Professional | 55 · Aftercare only | $8.13 | $12.30 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $8.13 Typical High $13.49 | Professional | 56 · Pre-op care only | $5.50 | $8.13 | $13.49 |
Where Arkansas sits
The same service costs 3.5 times more in Wisconsin than in Washington, DC. 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· 42nd 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.