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 $144.54 Median $162.18 Typical High $186.21 | Facility | None | $144.54 | $162.18 | $186.21 |
Aetna Setting Facility Modifier 52 · Reduced service Typical Low $79.43 Median $81.28 Typical High $93.33 | Facility | 52 · Reduced service | $79.43 | $81.28 | $93.33 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $23.99 Median $24.55 Typical High $28.18 | Facility | 55 · Aftercare only | $23.99 | $24.55 | $28.18 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $15.85 Median $16.22 Typical High $18.62 | Facility | 56 · Pre-op care only | $15.85 | $16.22 | $18.62 |
Aetna Setting Professional Modifier None Typical Low $128.82 Median $158.49 Typical High $199.53 | Professional | None | $128.82 | $158.49 | $199.53 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $77.62 Median $79.43 Typical High $93.33 | Professional | 52 · Reduced service | $77.62 | $79.43 | $93.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $23.99 Typical High $28.18 | Professional | 55 · Aftercare only | $23.99 | $23.99 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $15.85 Typical High $18.62 | Professional | 56 · Pre-op care only | $15.85 | $15.85 | $18.62 |
Ambetter Setting Professional Modifier None Typical Low $125.89 Median $158.49 Typical High $186.21 | Professional | None | $125.89 | $158.49 | $186.21 |
CareSource Setting Professional Modifier None Typical Low $144.54 Median $208.93 Typical High $245.47 | Professional | None | $144.54 | $208.93 | $245.47 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $173.78 Typical High $213.80 | Professional | None | $120.23 | $173.78 | $213.80 |
Qualchoice Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | None | $229.09 | $229.09 | $229.09 |
United Setting Professional Modifier None Typical Low $134.90 Median $162.18 Typical High $204.17 | Professional | None | $134.90 | $162.18 | $204.17 |
2 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 |
|---|---|---|---|---|---|
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | 25 · Same-day visit | $173.78 | $173.78 | $173.78 |
Qualchoice Setting Professional Modifier 25 · Same-day visit Typical Low $199.53 Median $199.53 Typical High $199.53 | Professional | 25 · Same-day visit | $199.53 | $199.53 | $199.53 |
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· 25th of 51
$162
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.