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 $5.50 Median $5.50 Typical High $5.50 | Facility | None | $5.50 | $5.50 | $5.50 |
Aetna Setting Professional Modifier None Typical Low $4.07 Median $5.50 Typical High $5.50 | Professional | None | $4.07 | $5.50 | $5.50 |
Ambetter Setting Professional Modifier None Typical Low $4.37 Median $4.37 Typical High $4.37 | Professional | None | $4.37 | $4.37 | $4.37 |
BCBS Arkansas Setting Professional Modifier None Typical Low $8.71 Median $8.71 Typical High $8.71 | Professional | None | $8.71 | $8.71 | $8.71 |
CareSource Setting Facility Modifier None Typical Low $6.92 Median $6.92 Typical High $6.92 | Facility | None | $6.92 | $6.92 | $6.92 |
CareSource Setting Professional Modifier None Typical Low $8.91 Median $8.91 Typical High $8.91 | Professional | None | $8.91 | $8.91 | $8.91 |
Cigna Setting Facility Modifier None Typical Low $4.17 Median $4.17 Typical High $4.47 | Facility | None | $4.17 | $4.17 | $4.47 |
Cigna Setting Professional Modifier None Typical Low $2.04 Median $3.55 Typical High $4.17 | Professional | None | $2.04 | $3.55 | $4.17 |
United Setting Professional Modifier None Typical Low $2.24 Median $3.24 Typical High $4.90 | Professional | None | $2.24 | $3.24 | $4.90 |
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 55 · Aftercare only Typical Low $0.83 Median $0.83 Typical High $0.83 | Professional | 55 · Aftercare only | $0.83 | $0.83 | $0.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.55 Median $0.55 Typical High $0.55 | Professional | 56 · Pre-op care only | $0.55 | $0.55 | $0.55 |
Qualchoice Setting Professional Modifier KX · Policy requirements met Typical Low $5.01 Median $5.01 Typical High $5.01 | Professional | KX · Policy requirements met | $5.01 | $5.01 | $5.01 |
Where Arkansas sits
The same service costs 2.1 times more in Kansas than in Colorado. 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· 23rd of 51
$4.90
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.