How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). 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 $144.54 Median $144.54 Typical High $173.78 | Facility | None | $144.54 | $144.54 | $173.78 |
Aetna Setting Professional Modifier None Typical Low $75.86 Median $144.54 Typical High $144.54 | Professional | None | $75.86 | $144.54 | $144.54 |
Ambetter Setting Professional Modifier None Typical Low $45.71 Median $114.82 Typical High $114.82 | Professional | None | $45.71 | $114.82 | $114.82 |
BCBS Setting Facility Modifier None Typical Low $131.83 Median $131.83 Typical High $177.83 | Facility | None | $131.83 | $131.83 | $177.83 |
BCBS Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $128.82 | Professional | None | $85.11 | $85.11 | $128.82 |
CareSource Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $114.82 | Professional | None | $74.13 | $74.13 | $114.82 |
Cigna Setting Facility Modifier None Typical Low $67.61 Median $147.91 Typical High $213.80 | Facility | None | $67.61 | $147.91 | $213.80 |
Cigna Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $120.23 | Professional | None | $60.26 | $60.26 | $120.23 |
Qualchoice Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $131.83 | Professional | None | $131.83 | $131.83 | $131.83 |
United Setting Facility Modifier None Typical Low $102.33 Median $102.33 Typical High $114.82 | Facility | None | $102.33 | $102.33 | $114.82 |
United Setting Professional Modifier None Typical Low $40.74 Median $47.86 Typical High $95.50 | Professional | None | $40.74 | $47.86 | $95.50 |
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 52 · Reduced service Typical Low $45.71 Median $72.44 Typical High $72.44 | Professional | 52 · Reduced service | $45.71 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $28.84 Typical High $28.84 | Professional | 53 · Discontinued | $18.20 | $28.84 | $28.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $67.61 Median $107.15 Typical High $107.15 | Professional | 54 · Surgery only | $67.61 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $21.88 Typical High $21.88 | Professional | 55 · Aftercare only | $13.49 | $21.88 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $14.45 Typical High $14.45 | Professional | 56 · Pre-op care only | $9.12 | $14.45 | $14.45 |
Where Arkansas sits
The same service costs 4.9 times more in Alaska than in Georgia. 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· 9th of 51
$129
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.