How much rates vary
Facilitymedian $58 · 10th to 90th $49 to $81Professionalmedian $63 · 10th to 90th $43 to $95
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 $47.86 Median $61.66 Typical High $81.28 | Facility | None | $47.86 | $61.66 | $81.28 |
Aetna Setting Professional Modifier None Typical Low $41.69 Median $60.26 Typical High $81.28 | Professional | None | $41.69 | $60.26 | $81.28 |
Ambetter Setting Professional Modifier None Typical Low $38.90 Median $64.57 Typical High $91.20 | Professional | None | $38.90 | $64.57 | $91.20 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $67.61 Median $77.62 Typical High $83.18 | Professional | 25 · Same-day visit | $67.61 | $77.62 | $83.18 |
BCBS Arkansas Setting Facility Modifier None Typical Low $48.98 Median $48.98 Typical High $69.18 | Facility | None | $48.98 | $48.98 | $69.18 |
BCBS Arkansas Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $95.50 | Professional | None | $63.10 | $63.10 | $95.50 |
CareSource Setting Professional Modifier None Typical Low $63.10 Median $91.20 Typical High $107.15 | Professional | None | $63.10 | $91.20 | $107.15 |
Cigna Setting Facility Modifier None Typical Low $95.50 Median $109.65 Typical High $151.36 | Facility | None | $95.50 | $109.65 | $151.36 |
Cigna Setting Professional Modifier None Typical Low $46.77 Median $67.61 Typical High $91.20 | Professional | None | $46.77 | $67.61 | $91.20 |
Qualchoice Setting Professional Modifier None Typical Low $44.67 Median $72.44 Typical High $104.71 | Professional | None | $44.67 | $72.44 | $104.71 |
Qualchoice Setting Professional Modifier 25 · Same-day visit Typical Low $77.62 Median $89.13 Typical High $95.50 | Professional | 25 · Same-day visit | $77.62 | $89.13 | $95.50 |
United Setting Professional Modifier None Typical Low $42.66 Median $61.66 Typical High $83.18 | Professional | None | $42.66 | $61.66 | $83.18 |
10 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 Facility Modifier 52 · Reduced service Typical Low $26.92 Median $28.18 Typical High $38.90 | Facility | 52 · Reduced service | $26.92 | $28.18 | $38.90 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $8.13 Median $8.51 Typical High $11.75 | Facility | 55 · Aftercare only | $8.13 | $8.51 | $11.75 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $5.37 Median $5.75 Typical High $7.76 | Facility | 56 · Pre-op care only | $5.37 | $5.75 | $7.76 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $26.92 Median $28.18 Typical High $38.90 | Professional | 52 · Reduced service | $26.92 | $28.18 | $38.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $8.51 Typical High $11.75 | Professional | 55 · Aftercare only | $8.13 | $8.51 | $11.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $5.75 Typical High $7.76 | Professional | 56 · Pre-op care only | $5.37 | $5.75 | $7.76 |
Ambetter Setting Professional Modifier 93 · Audio-only telehealth Typical Low $79.43 Median $79.43 Typical High $79.43 | Professional | 93 · Audio-only telehealth | $79.43 | $79.43 | $79.43 |
Ambetter Setting Professional Modifier CG · Policy criteria applied Typical Low $79.43 Median $79.43 Typical High $79.43 | Professional | CG · Policy criteria applied | $79.43 | $79.43 | $79.43 |
Qualchoice Setting Professional Modifier 93 · Audio-only telehealth Typical Low $91.20 Median $91.20 Typical High $91.20 | Professional | 93 · Audio-only telehealth | $91.20 | $91.20 | $91.20 |
Qualchoice Setting Professional Modifier CG · Policy criteria applied Typical Low $91.20 Median $91.20 Typical High $91.20 | Professional | CG · Policy criteria applied | $91.20 | $91.20 | $91.20 |
Where Arkansas sits
The same service costs 2.2 times more in Alaska than in New Jersey. 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· 32nd of 51
$63.10
AK $107NJ $48.98
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.