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 $257.04 Median $257.04 Typical High $257.04 | Facility | None | $257.04 | $257.04 | $257.04 |
Aetna Setting Professional Modifier None Typical Low $194.98 Median $257.04 Typical High $257.04 | Professional | None | $194.98 | $257.04 | $257.04 |
Ambetter Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $380.19 | Professional | None | $323.59 | $323.59 | $380.19 |
BCBS Arkansas Setting Professional Modifier None Typical Low $398.11 Median $436.52 Typical High $524.81 | Professional | None | $398.11 | $436.52 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $316.23 Median $316.23 Typical High $380.19 | Facility | None | $316.23 | $316.23 | $380.19 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $229.09 Typical High $316.23 | Professional | None | $147.91 | $229.09 | $316.23 |
Qualchoice Setting Professional Modifier None Typical Low $371.54 Median $436.52 Typical High $436.52 | Professional | None | $371.54 | $436.52 | $436.52 |
United Setting Facility Modifier None Typical Low $245.47 Median $478.63 Typical High $562.34 | Facility | None | $245.47 | $478.63 | $562.34 |
United Setting Professional Modifier None Typical Low $162.18 Median $213.80 Typical High $316.23 | Professional | None | $162.18 | $213.80 | $316.23 |
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 $114.82 Median $128.82 Typical High $128.82 | Professional | 52 · Reduced service | $114.82 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $51.29 Typical High $51.29 | Professional | 53 · Discontinued | $46.77 | $51.29 | $51.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $38.90 Typical High $38.90 | Professional | 55 · Aftercare only | $34.67 | $38.90 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $25.70 Typical High $25.70 | Professional | 56 · Pre-op care only | $22.91 | $25.70 | $25.70 |
Where Arkansas sits
The same service costs 2.6 times more in Hawaii than in Arizona. 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· 12th of 51
$398
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.