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 $15.14 Median $15.14 Typical High $15.14 | Facility | None | $15.14 | $15.14 | $15.14 |
Aetna Setting Professional Modifier None Typical Low $14.79 Median $15.14 Typical High $15.14 | Professional | None | $14.79 | $15.14 | $15.14 |
BCBS Arkansas Setting Professional Modifier None Typical Low $3.98 Median $4.37 Typical High $5.25 | Professional | None | $3.98 | $4.37 | $5.25 |
Cigna Setting Facility Modifier None Typical Low $10.00 Median $20.42 Typical High $20.42 | Facility | None | $10.00 | $20.42 | $20.42 |
Cigna Setting Professional Modifier None Typical Low $7.24 Median $15.14 Typical High $15.14 | Professional | None | $7.24 | $15.14 | $15.14 |
United Setting Professional Modifier None Typical Low $1.45 Median $1.86 Typical High $3.39 | Professional | None | $1.45 | $1.86 | $3.39 |
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 $7.41 Median $7.59 Typical High $7.59 | Professional | 52 · Reduced service | $7.41 | $7.59 | $7.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.95 Median $3.02 Typical High $3.02 | Professional | 53 · Discontinued | $2.95 | $3.02 | $3.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.24 Median $2.29 Typical High $2.29 | Professional | 55 · Aftercare only | $2.24 | $2.29 | $2.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.48 Median $1.51 Typical High $1.51 | Professional | 56 · Pre-op care only | $1.48 | $1.51 | $1.51 |
Where Arkansas sits
The same service costs 4.8 times more in Maryland 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· 43rd of 51
$5.25
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.