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 $40.74 Median $40.74 Typical High $40.74 | Facility | None | $40.74 | $40.74 | $40.74 |
Aetna Setting Professional Modifier None Typical Low $38.90 Median $40.74 Typical High $40.74 | Professional | None | $38.90 | $40.74 | $40.74 |
BCBS Setting Professional Modifier None Typical Low $63.10 Median $70.79 Typical High $83.18 | Professional | None | $63.10 | $70.79 | $83.18 |
Cigna Setting Facility Modifier None Typical Low $46.77 Median $46.77 Typical High $60.26 | Facility | None | $46.77 | $46.77 | $60.26 |
Cigna Setting Professional Modifier None Typical Low $25.70 Median $33.88 Typical High $46.77 | Professional | None | $25.70 | $33.88 | $46.77 |
United Setting Facility Modifier None Typical Low $19.05 Median $83.18 Typical High $97.72 | Facility | None | $19.05 | $83.18 | $97.72 |
United Setting Professional Modifier None Typical Low $27.54 Median $36.31 Typical High $50.12 | Professional | None | $27.54 | $36.31 | $50.12 |
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 $19.95 Median $20.42 Typical High $20.42 | Professional | 52 · Reduced service | $19.95 | $20.42 | $20.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.94 Median $8.13 Typical High $8.13 | Professional | 53 · Discontinued | $7.94 | $8.13 | $8.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.03 Median $6.17 Typical High $6.17 | Professional | 55 · Aftercare only | $6.03 | $6.17 | $6.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.98 Median $4.07 Typical High $4.07 | Professional | 56 · Pre-op care only | $3.98 | $4.07 | $4.07 |
Where Arkansas sits
The same service costs 2.9 times more in Kansas than in Delaware. 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
$63.10
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.