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 $6.17 Median $6.17 Typical High $6.17 | Facility | None | $6.17 | $6.17 | $6.17 |
Aetna Setting Professional Modifier None Typical Low $5.37 Median $6.17 Typical High $6.17 | Professional | None | $5.37 | $6.17 | $6.17 |
Ambetter Setting Professional Modifier KX · Policy requirements met Typical Low $4.79 Median $4.79 Typical High $4.79 | Professional | KX · Policy requirements met | $4.79 | $4.79 | $4.79 |
BCBS Arkansas Setting Professional Modifier None Typical Low $6.61 Median $7.24 Typical High $8.71 | Professional | None | $6.61 | $7.24 | $8.71 |
CareSource Setting Facility Modifier None Typical Low $7.59 Median $7.59 Typical High $7.59 | Facility | None | $7.59 | $7.59 | $7.59 |
CareSource Setting Professional Modifier None Typical Low $10.00 Median $10.00 Typical High $10.00 | Professional | None | $10.00 | $10.00 | $10.00 |
Cigna Setting Facility Modifier None Typical Low $5.37 Median $5.37 Typical High $5.37 | Facility | None | $5.37 | $5.37 | $5.37 |
Cigna Setting Professional Modifier None Typical Low $2.82 Median $4.57 Typical High $5.37 | Professional | None | $2.82 | $4.57 | $5.37 |
Qualchoice Setting Professional Modifier KX · Policy requirements met Typical Low $5.62 Median $5.62 Typical High $5.62 | Professional | KX · Policy requirements met | $5.62 | $5.62 | $5.62 |
United Setting Professional Modifier None Typical Low $2.63 Median $3.80 Typical High $5.50 | Professional | None | $2.63 | $3.80 | $5.50 |
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 |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.91 Median $0.91 Typical High $0.91 | Professional | 55 · Aftercare only | $0.91 | $0.91 | $0.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.62 Median $0.62 Typical High $0.62 | Professional | 56 · Pre-op care only | $0.62 | $0.62 | $0.62 |
Where Arkansas sits
The same service costs 4.2 times more in Hawaii than in Kentucky. 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· 18th of 51
$6.61
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.