How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $95.50 Median $100.00 Typical High $125.89 | Facility | None | $95.50 | $100.00 | $125.89 |
Aetna Setting Professional Modifier None Typical Low $95.50 Median $109.65 Typical High $125.89 | Professional | None | $95.50 | $109.65 | $125.89 |
Ambetter Setting Professional Modifier None Typical Low $123.03 Median $141.25 Typical High $165.96 | Professional | None | $123.03 | $141.25 | $165.96 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $123.03 Median $144.54 Typical High $165.96 | Professional | 25 · Same-day visit | $123.03 | $144.54 | $165.96 |
BCBS Arkansas Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $169.82 | Professional | None | $169.82 | $169.82 | $169.82 |
CareSource Setting Professional Modifier None Typical Low $114.82 Median $165.96 Typical High $194.98 | Professional | None | $114.82 | $165.96 | $194.98 |
Cigna Setting Professional Modifier None Typical Low $89.13 Median $123.03 Typical High $162.18 | Professional | None | $89.13 | $123.03 | $162.18 |
Qualchoice Setting Professional Modifier None Typical Low $162.18 Median $173.78 Typical High $199.53 | Professional | None | $162.18 | $173.78 | $199.53 |
Qualchoice Setting Professional Modifier 25 · Same-day visit Typical Low $141.25 Median $165.96 Typical High $190.55 | Professional | 25 · Same-day visit | $141.25 | $165.96 | $190.55 |
United Setting Professional Modifier None Typical Low $81.28 Median $109.65 Typical High $144.54 | Professional | None | $81.28 | $109.65 | $144.54 |
3 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 $47.86 Median $50.12 Typical High $63.10 | Professional | 52 · Reduced service | $47.86 | $50.12 | $63.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $15.14 Typical High $19.05 | Professional | 55 · Aftercare only | $14.45 | $15.14 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $10.00 Typical High $12.59 | Professional | 56 · Pre-op care only | $9.55 | $10.00 | $12.59 |
Where Arkansas sits
The same service costs 2.7 times more in Alaska 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· 26th of 51
$123
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.