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 $3.63 Median $3.63 Typical High $3.63 | Facility | None | $3.63 | $3.63 | $3.63 |
Aetna Setting Professional Modifier None Typical Low $2.51 Median $3.63 Typical High $3.63 | Professional | None | $2.51 | $3.63 | $3.63 |
BCBS Arkansas Setting Professional Modifier None Typical Low $3.89 Median $4.27 Typical High $5.13 | Professional | None | $3.89 | $4.27 | $5.13 |
Cigna Setting Facility Modifier None Typical Low $2.69 Median $2.69 Typical High $3.31 | Facility | None | $2.69 | $2.69 | $3.31 |
Cigna Setting Professional Modifier None Typical Low $1.41 Median $2.29 Typical High $2.69 | Professional | None | $1.41 | $2.29 | $2.69 |
United Setting Professional Modifier None Typical Low $1.32 Median $2.09 Typical High $3.02 | Professional | None | $1.32 | $2.09 | $3.02 |
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 $1.66 Median $1.82 Typical High $1.82 | Professional | 52 · Reduced service | $1.66 | $1.82 | $1.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.66 Median $0.72 Typical High $0.72 | Professional | 53 · Discontinued | $0.66 | $0.72 | $0.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.50 Median $0.54 Typical High $0.54 | Professional | 55 · Aftercare only | $0.50 | $0.54 | $0.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.33 Median $0.36 Typical High $0.36 | Professional | 56 · Pre-op care only | $0.33 | $0.36 | $0.36 |
Where Arkansas sits
The same service costs 2.1 times more in Montana than in New Hampshire. 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· 7th of 51
$3.89
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.