How much rates vary
Facilitymedian $45 · 10th to 90th $28 to $60Professionalmedian $41 · 10th to 90th $28 to $63
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 $27.54 Median $35.48 Typical High $47.86 | Facility | None | $27.54 | $35.48 | $47.86 |
Aetna Setting Professional Modifier None Typical Low $27.54 Median $35.48 Typical High $47.86 | Professional | None | $27.54 | $35.48 | $47.86 |
Ambetter Setting Professional Modifier None Typical Low $28.84 Median $53.70 Typical High $63.10 | Professional | None | $28.84 | $53.70 | $63.10 |
BCBS Arkansas Setting Facility Modifier None Typical Low $44.67 Median $44.67 Typical High $63.10 | Facility | None | $44.67 | $44.67 | $63.10 |
BCBS Arkansas Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $58.88 | Professional | None | $37.15 | $37.15 | $58.88 |
CareSource Setting Professional Modifier None Typical Low $50.12 Median $72.44 Typical High $85.11 | Professional | None | $50.12 | $72.44 | $85.11 |
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 $23.99 Median $39.81 Typical High $57.54 | Professional | None | $23.99 | $39.81 | $57.54 |
Qualchoice Setting Professional Modifier None Typical Low $33.11 Median $61.66 Typical High $72.44 | Professional | None | $33.11 | $61.66 | $72.44 |
United Setting Professional Modifier None Typical Low $22.39 Median $36.31 Typical High $53.70 | Professional | None | $22.39 | $36.31 | $53.70 |
20 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 $13.80 Median $14.45 Typical High $22.91 | Facility | 52 · Reduced service | $13.80 | $14.45 | $22.91 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $4.07 Median $4.37 Typical High $6.92 | Facility | 55 · Aftercare only | $4.07 | $4.37 | $6.92 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $2.75 Median $2.88 Typical High $4.57 | Facility | 56 · Pre-op care only | $2.75 | $2.88 | $4.57 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $13.80 Median $17.78 Typical High $22.91 | Professional | 52 · Reduced service | $13.80 | $17.78 | $22.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.07 Median $5.37 Typical High $6.92 | Professional | 55 · Aftercare only | $4.07 | $5.37 | $6.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.75 Median $3.55 Typical High $4.57 | Professional | 56 · Pre-op care only | $2.75 | $3.55 | $4.57 |
Ambetter Setting Professional Modifier 24 · Unrelated visit after surgery Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | 24 · Unrelated visit after surgery | $63.10 | $63.10 | $63.10 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $46.77 Median $54.95 Typical High $63.10 | Professional | 25 · Same-day visit | $46.77 | $54.95 | $63.10 |
Ambetter Setting Professional Modifier 57 · Decision for surgery Typical Low $54.95 Median $54.95 Typical High $54.95 | Professional | 57 · Decision for surgery | $54.95 | $54.95 | $54.95 |
Ambetter Setting Professional Modifier 93 · Audio-only telehealth Typical Low $53.70 Median $53.70 Typical High $60.26 | Professional | 93 · Audio-only telehealth | $53.70 | $53.70 | $60.26 |
Ambetter Setting Professional Modifier EP · Child screening program Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | EP · Child screening program | $63.10 | $63.10 | $63.10 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $54.95 Median $54.95 Typical High $54.95 | Professional | GC · Resident with teaching physician | $54.95 | $54.95 | $54.95 |
Ambetter Setting Professional Modifier U5 · State-defined Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | U5 · State-defined | $63.10 | $63.10 | $63.10 |
Qualchoice Setting Professional Modifier 25 · Same-day visit Typical Low $53.70 Median $63.10 Typical High $72.44 | Professional | 25 · Same-day visit | $53.70 | $63.10 | $72.44 |
Qualchoice Setting Professional Modifier 57 · Decision for surgery Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | 57 · Decision for surgery | $63.10 | $63.10 | $63.10 |
Qualchoice Setting Professional Modifier 93 · Audio-only telehealth Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | 93 · Audio-only telehealth | $61.66 | $61.66 | $61.66 |
Qualchoice Setting Professional Modifier GC · Resident with teaching physician Typical Low $63.10 Median $63.10 Typical High $77.62 | Professional | GC · Resident with teaching physician | $63.10 | $63.10 | $77.62 |
Qualchoice Setting Professional Modifier GE · Resident, primary care exception Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | GE · Resident, primary care exception | $63.10 | $63.10 | $63.10 |
Qualchoice Setting Professional Modifier TH · Pregnancy care Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | TH · Pregnancy care | $63.10 | $63.10 | $63.10 |
Qualchoice Setting Professional Modifier U5 · State-defined Typical Low $72.44 Median $72.44 Typical High $72.44 | Professional | U5 · State-defined | $72.44 | $72.44 | $72.44 |
Where Arkansas sits
The same service costs 2.4 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· 38th of 51
$40.74
AK $77.62NJ $32.36
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.