How much rates vary
Facilitymedian $83 · 10th to 90th $74 to $112Professionalmedian $100 · 10th to 90th $69 to $138
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 $66.07 Median $89.13 Typical High $117.49 | Facility | None | $66.07 | $89.13 | $117.49 |
Aetna Setting Professional Modifier None Typical Low $64.57 Median $89.13 Typical High $117.49 | Professional | None | $64.57 | $89.13 | $117.49 |
Ambetter Setting Professional Modifier None Typical Low $66.07 Median $102.33 Typical High $131.83 | Professional | None | $66.07 | $102.33 | $131.83 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $77.62 Median $107.15 Typical High $134.90 | Professional | 25 · Same-day visit | $77.62 | $107.15 | $134.90 |
BCBS Arkansas Setting Facility Modifier None Typical Low $74.13 Median $74.13 Typical High $104.71 | Facility | None | $74.13 | $74.13 | $104.71 |
BCBS Arkansas Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $138.04 | Professional | None | $100.00 | $100.00 | $138.04 |
CareSource Setting Professional Modifier None Typical Low $100.00 Median $144.54 Typical High $169.82 | Professional | None | $100.00 | $144.54 | $169.82 |
Cigna Setting Facility Modifier None Typical Low $95.50 Median $125.89 Typical High $151.36 | Facility | None | $95.50 | $125.89 | $151.36 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $97.72 Typical High $138.04 | Professional | None | $72.44 | $97.72 | $138.04 |
Qualchoice Setting Professional Modifier None Typical Low $89.13 Median $120.23 Typical High $154.88 | Professional | None | $89.13 | $120.23 | $154.88 |
Qualchoice Setting Professional Modifier 25 · Same-day visit Typical Low $75.86 Median $123.03 Typical High $154.88 | Professional | 25 · Same-day visit | $75.86 | $123.03 | $154.88 |
United Setting Professional Modifier None Typical Low $66.07 Median $91.20 Typical High $120.23 | Professional | None | $66.07 | $91.20 | $120.23 |
11 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 $40.74 Median $43.65 Typical High $56.23 | Facility | 52 · Reduced service | $40.74 | $43.65 | $56.23 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $12.30 Median $12.88 Typical High $16.98 | Facility | 55 · Aftercare only | $12.30 | $12.88 | $16.98 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $8.13 Median $8.71 Typical High $11.22 | Facility | 56 · Pre-op care only | $8.13 | $8.71 | $11.22 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $40.74 Median $43.65 Typical High $56.23 | Professional | 52 · Reduced service | $40.74 | $43.65 | $56.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $12.88 Typical High $16.98 | Professional | 55 · Aftercare only | $12.30 | $12.88 | $16.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $8.71 Typical High $11.22 | Professional | 56 · Pre-op care only | $8.13 | $8.71 | $11.22 |
Ambetter Setting Professional Modifier 24 · Unrelated visit after surgery Typical Low $131.83 Median $131.83 Typical High $141.25 | Professional | 24 · Unrelated visit after surgery | $131.83 | $131.83 | $141.25 |
Ambetter Setting Professional Modifier 57 · Decision for surgery Typical Low $123.03 Median $123.03 Typical High $123.03 | Professional | 57 · Decision for surgery | $123.03 | $123.03 | $123.03 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $138.04 Median $141.25 Typical High $154.88 | Professional | GC · Resident with teaching physician | $138.04 | $141.25 | $154.88 |
Qualchoice Setting Professional Modifier 57 · Decision for surgery Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | 57 · Decision for surgery | $144.54 | $144.54 | $144.54 |
Qualchoice Setting Professional Modifier GC · Resident with teaching physician Typical Low $162.18 Median $162.18 Typical High $177.83 | Professional | GC · Resident with teaching physician | $162.18 | $162.18 | $177.83 |
Where Arkansas sits
The same service costs 2.3 times more in Alaska than in Alabama. 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· 27th of 51
$100
AK $170AL $74.13
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.