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 $31.62 Median $31.62 Typical High $31.62 | Facility | None | $31.62 | $31.62 | $31.62 |
Aetna Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $40.74 | Professional | None | $31.62 | $31.62 | $40.74 |
Ambetter Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | None | $50.12 | $50.12 | $50.12 |
BCBS Arkansas Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $69.18 | Professional | None | $51.29 | $51.29 | $69.18 |
CareSource Setting Facility Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Facility | None | $60.26 | $60.26 | $60.26 |
CareSource Setting Professional Modifier None Typical Low $60.26 Median $85.11 Typical High $85.11 | Professional | None | $60.26 | $85.11 | $85.11 |
Cigna Setting Facility Modifier None Typical Low $40.74 Median $40.74 Typical High $50.12 | Facility | None | $40.74 | $40.74 | $50.12 |
Cigna Setting Professional Modifier None Typical Low $34.67 Median $34.67 Typical High $34.67 | Professional | None | $34.67 | $34.67 | $34.67 |
United Setting Professional Modifier None Typical Low $20.42 Median $32.36 Typical High $50.12 | Professional | None | $20.42 | $32.36 | $50.12 |
5 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 $4.68 Median $4.68 Typical High $6.17 | Professional | 55 · Aftercare only | $4.68 | $4.68 | $6.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.16 Median $3.16 Typical High $4.07 | Professional | 56 · Pre-op care only | $3.16 | $3.16 | $4.07 |
Ambetter Setting Professional Modifier KX · Policy requirements met Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | KX · Policy requirements met | $61.66 | $61.66 | $61.66 |
Cigna Setting Professional Modifier RR · Rental Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | RR · Rental | $100.00 | $100.00 | $100.00 |
Qualchoice Setting Professional Modifier KX · Policy requirements met Typical Low $70.79 Median $70.79 Typical High $70.79 | Professional | KX · Policy requirements met | $70.79 | $70.79 | $70.79 |
Where Arkansas sits
The same service costs 6.6 times more in Hawaii than in Wyoming. 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· 17th of 51
$51.29
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.