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 $16.60 Median $16.60 Typical High $16.60 | Facility | None | $16.60 | $16.60 | $16.60 |
Aetna Setting Professional Modifier None Typical Low $15.49 Median $16.60 Typical High $16.60 | Professional | None | $15.49 | $16.60 | $16.60 |
Ambetter Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $24.55 | Professional | None | $24.55 | $24.55 | $24.55 |
BCBS Arkansas Setting Professional Modifier None Typical Low $25.70 Median $28.18 Typical High $33.88 | Professional | None | $25.70 | $28.18 | $33.88 |
Cigna Setting Facility Modifier None Typical Low $22.39 Median $22.39 Typical High $31.62 | Facility | None | $22.39 | $22.39 | $31.62 |
Cigna Setting Professional Modifier None Typical Low $10.72 Median $16.22 Typical High $22.39 | Professional | None | $10.72 | $16.22 | $22.39 |
Qualchoice Setting Professional Modifier None Typical Low $28.18 Median $28.18 Typical High $28.18 | Professional | None | $28.18 | $28.18 | $28.18 |
United Setting Facility Modifier None Typical Low $19.95 Median $34.67 Typical High $40.74 | Facility | None | $19.95 | $34.67 | $40.74 |
United Setting Professional Modifier None Typical Low $11.48 Median $14.79 Typical High $22.39 | Professional | None | $11.48 | $14.79 | $22.39 |
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 $8.13 Median $8.32 Typical High $8.32 | Professional | 52 · Reduced service | $8.13 | $8.32 | $8.32 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.24 Median $3.31 Typical High $3.31 | Professional | 53 · Discontinued | $3.24 | $3.31 | $3.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.40 Median $2.51 Typical High $2.51 | Professional | 55 · Aftercare only | $2.40 | $2.51 | $2.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.62 Median $1.66 Typical High $1.66 | Professional | 56 · Pre-op care only | $1.62 | $1.66 | $1.66 |
Where Arkansas sits
The same service costs 3.7 times more in Hawaii than in Florida. 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· 16th of 51
$25.70
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.