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 $85.11 Median $89.13 Typical High $112.20 | Facility | None | $85.11 | $89.13 | $112.20 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $95.50 Typical High $112.20 | Professional | None | $83.18 | $95.50 | $112.20 |
Ambetter Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $144.54 | Professional | None | $125.89 | $125.89 | $144.54 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $107.15 Median $125.89 Typical High $144.54 | Professional | 25 · Same-day visit | $107.15 | $125.89 | $144.54 |
BCBS Arkansas Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | None | $151.36 | $151.36 | $151.36 |
CareSource Setting Professional Modifier None Typical Low $102.33 Median $147.91 Typical High $169.82 | Professional | None | $102.33 | $147.91 | $169.82 |
Cigna Setting Professional Modifier None Typical Low $79.43 Median $107.15 Typical High $141.25 | Professional | None | $79.43 | $107.15 | $141.25 |
Qualchoice Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $165.96 | Professional | None | $147.91 | $147.91 | $165.96 |
Qualchoice Setting Professional Modifier 25 · Same-day visit Typical Low $123.03 Median $147.91 Typical High $165.96 | Professional | 25 · Same-day visit | $123.03 | $147.91 | $165.96 |
United Setting Professional Modifier None Typical Low $69.18 Median $95.50 Typical High $128.82 | Professional | None | $69.18 | $95.50 | $128.82 |
5 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 $42.66 Median $44.67 Typical High $56.23 | Professional | 52 · Reduced service | $42.66 | $44.67 | $56.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $13.49 Typical High $16.98 | Professional | 55 · Aftercare only | $12.88 | $13.49 | $16.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $8.91 Typical High $11.22 | Professional | 56 · Pre-op care only | $8.51 | $8.91 | $11.22 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | GC · Resident with teaching physician | $144.54 | $144.54 | $144.54 |
Qualchoice Setting Professional Modifier GC · Resident with teaching physician Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | GC · Resident with teaching physician | $165.96 | $165.96 | $165.96 |
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· 22nd of 51
$112
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.