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 $331.13 Median $331.13 Typical High $331.13 | Facility | None | $331.13 | $331.13 | $331.13 |
Aetna Setting Professional Modifier None Typical Low $295.12 Median $331.13 Typical High $331.13 | Professional | None | $295.12 | $331.13 | $331.13 |
BCBS Arkansas Setting Professional Modifier None Typical Low $512.86 Median $575.44 Typical High $691.83 | Professional | None | $512.86 | $575.44 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $416.87 Median $416.87 Typical High $489.78 | Facility | None | $416.87 | $416.87 | $489.78 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $309.03 Typical High $416.87 | Professional | None | $199.53 | $309.03 | $416.87 |
United Setting Facility Modifier None Typical Low $363.08 Median $645.65 Typical High $758.58 | Facility | None | $363.08 | $645.65 | $758.58 |
United Setting Professional Modifier None Typical Low $213.80 Median $281.84 Typical High $426.58 | Professional | None | $213.80 | $281.84 | $426.58 |
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 $162.18 Median $165.96 Typical High $165.96 | Professional | 52 · Reduced service | $162.18 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $66.07 Typical High $66.07 | Professional | 53 · Discontinued | $64.57 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $50.12 Typical High $50.12 | Professional | 55 · Aftercare only | $48.98 | $50.12 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $33.11 Typical High $33.11 | Professional | 56 · Pre-op care only | $32.36 | $33.11 | $33.11 |
Where Arkansas sits
The same service costs 2.9 times more in Hawaii than in Washington, DC. 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· 15th of 51
$513
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.