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 $0.31 Median $0.31 Typical High $0.31 | Facility | None | $0.31 | $0.31 | $0.31 |
Aetna Setting Professional Modifier None Typical Low $0.31 Median $0.31 Typical High $11.22 | Professional | None | $0.31 | $0.31 | $11.22 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.16 Median $0.16 Typical High $5.62 | Professional | 52 · Reduced service | $0.16 | $0.16 | $5.62 |
Cigna Setting Facility Modifier None Typical Low $9.77 Median $13.18 Typical High $13.80 | Facility | None | $9.77 | $13.18 | $13.80 |
Cigna Setting Professional Modifier None Typical Low $9.77 Median $9.77 Typical High $9.77 | Professional | None | $9.77 | $9.77 | $9.77 |
United Setting Facility Modifier None Typical Low $20.89 Median $20.89 Typical High $20.89 | Facility | None | $20.89 | $20.89 | $20.89 |
United Setting Professional Modifier None Typical Low $4.90 Median $6.31 Typical High $7.76 | Professional | None | $4.90 | $6.31 | $7.76 |
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 53 · Discontinued Typical Low $1.29 Median $2.24 Typical High $4.27 | Professional | 53 · Discontinued | $1.29 | $2.24 | $4.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.95 Median $1.66 Typical High $3.16 | Professional | 55 · Aftercare only | $0.95 | $1.66 | $3.16 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.65 Median $1.12 Typical High $2.09 | Professional | 56 · Pre-op care only | $0.65 | $1.12 | $2.09 |
Where Arkansas sits
The same service costs 46.8 times more in New York than in Arkansas. 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· 51st of 51
$6.92
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.