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 $102.33 Median $102.33 Typical High $102.33 | Facility | None | $102.33 | $102.33 | $102.33 |
Aetna Setting Professional Modifier None Typical Low $85.11 Median $102.33 Typical High $102.33 | Professional | None | $85.11 | $102.33 | $102.33 |
Ambetter Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $87.10 | Professional | None | $87.10 | $87.10 | $87.10 |
BCBS Arkansas Setting Professional Modifier None Typical Low $158.49 Median $173.78 Typical High $208.93 | Professional | None | $158.49 | $173.78 | $208.93 |
Cigna Setting Facility Modifier None Typical Low $87.10 Median $87.10 Typical High $151.36 | Facility | None | $87.10 | $87.10 | $151.36 |
Cigna Setting Professional Modifier None Typical Low $48.98 Median $63.10 Typical High $87.10 | Professional | None | $48.98 | $63.10 | $87.10 |
Qualchoice Setting Professional Modifier None Typical Low $22.91 Median $22.91 Typical High $22.91 | Professional | None | $22.91 | $22.91 | $22.91 |
United Setting Facility Modifier None Typical Low $39.81 Median $158.49 Typical High $186.21 | Facility | None | $39.81 | $158.49 | $186.21 |
United Setting Professional Modifier None Typical Low $52.48 Median $85.11 Typical High $123.03 | Professional | None | $52.48 | $85.11 | $123.03 |
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 $42.66 Median $51.29 Typical High $51.29 | Professional | 52 · Reduced service | $42.66 | $51.29 | $51.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $20.42 Typical High $20.42 | Professional | 53 · Discontinued | $16.98 | $20.42 | $20.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $15.49 Typical High $15.49 | Professional | 55 · Aftercare only | $12.88 | $15.49 | $15.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $10.23 Typical High $10.23 | Professional | 56 · Pre-op care only | $8.51 | $10.23 | $10.23 |
Where Arkansas sits
The same service costs 2.5 times more in Arkansas 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· 1st of 51
$158
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.