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 $208.93 Median $208.93 Typical High $208.93 | Facility | None | $208.93 | $208.93 | $208.93 |
Aetna Setting Professional Modifier None Typical Low $173.78 Median $208.93 Typical High $208.93 | Professional | None | $173.78 | $208.93 | $208.93 |
BCBS Arkansas Setting Facility Modifier None Typical Low $186.21 Median $186.21 Typical High $186.21 | Facility | None | $186.21 | $186.21 | $186.21 |
BCBS Arkansas Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $186.21 | Professional | None | $186.21 | $186.21 | $186.21 |
Cigna Setting Facility Modifier None Typical Low $162.18 Median $234.42 Typical High $323.59 | Facility | None | $162.18 | $234.42 | $323.59 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | None | $173.78 | $173.78 | $173.78 |
United Setting Facility Modifier None Typical Low $173.78 Median $173.78 Typical High $173.78 | Facility | None | $173.78 | $173.78 | $173.78 |
United Setting Professional Modifier None Typical Low $154.88 Median $162.18 Typical High $208.93 | Professional | None | $154.88 | $162.18 | $208.93 |
6 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 $87.10 Median $104.71 Typical High $104.71 | Professional | 52 · Reduced service | $87.10 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $41.69 Typical High $41.69 | Professional | 53 · Discontinued | $34.67 | $41.69 | $41.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $154.88 Typical High $154.88 | Professional | 54 · Surgery only | $128.82 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $30.90 Typical High $30.90 | Professional | 55 · Aftercare only | $25.70 | $30.90 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $20.89 Typical High $20.89 | Professional | 56 · Pre-op care only | $17.38 | $20.89 | $20.89 |
Ambetter Setting Professional Modifier JW · Drug discarded Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | JW · Drug discarded | $173.78 | $173.78 | $173.78 |
Where Arkansas sits
Rates are fairly even across states for this service. 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· 4th of 51
$186
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.