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 $3.16 Median $3.16 Typical High $3.16 | Facility | None | $3.16 | $3.16 | $3.16 |
Aetna Setting Professional Modifier None Typical Low $2.40 Median $3.16 Typical High $3.16 | Professional | None | $2.40 | $3.16 | $3.16 |
Ambetter Setting Professional Modifier None Typical Low $2.45 Median $2.45 Typical High $2.45 | Professional | None | $2.45 | $2.45 | $2.45 |
BCBS Arkansas Setting Professional Modifier None Typical Low $4.90 Median $4.90 Typical High $4.90 | Professional | None | $4.90 | $4.90 | $4.90 |
Cigna Setting Facility Modifier None Typical Low $2.34 Median $2.34 Typical High $2.51 | Facility | None | $2.34 | $2.34 | $2.51 |
Cigna Setting Professional Modifier None Typical Low $1.23 Median $2.00 Typical High $2.34 | Professional | None | $1.23 | $2.00 | $2.34 |
Qualchoice Setting Professional Modifier None Typical Low $2.82 Median $2.82 Typical High $2.82 | Professional | None | $2.82 | $2.82 | $2.82 |
United Setting Professional Modifier None Typical Low $1.26 Median $1.82 Typical High $2.75 | Professional | None | $1.26 | $1.82 | $2.75 |
4 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 $1.58 Median $1.58 Typical High $1.58 | Professional | 52 · Reduced service | $1.58 | $1.58 | $1.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.63 Median $0.63 Typical High $0.63 | Professional | 53 · Discontinued | $0.63 | $0.63 | $0.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.47 Median $0.47 Typical High $0.47 | Professional | 55 · Aftercare only | $0.47 | $0.47 | $0.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.31 Median $0.31 Typical High $0.31 | Professional | 56 · Pre-op care only | $0.31 | $0.31 | $0.31 |
Where Arkansas sits
The same service costs 2.2 times more in Kansas than in Delaware. 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· 19th of 51
$2.82
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.