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 $83.18 Median $83.18 Typical High $83.18 | Facility | None | $83.18 | $83.18 | $83.18 |
Aetna Setting Professional Modifier None Typical Low $69.18 Median $83.18 Typical High $83.18 | Professional | None | $69.18 | $83.18 | $83.18 |
BCBS Arkansas Setting Professional Modifier None Typical Low $128.82 Median $141.25 Typical High $169.82 | Professional | None | $128.82 | $141.25 | $169.82 |
Cigna Setting Facility Modifier None Typical Low $75.86 Median $75.86 Typical High $123.03 | Facility | None | $75.86 | $75.86 | $123.03 |
Cigna Setting Professional Modifier None Typical Low $41.69 Median $54.95 Typical High $75.86 | Professional | None | $41.69 | $54.95 | $75.86 |
United Setting Facility Modifier None Typical Low $77.62 Median $134.90 Typical High $158.49 | Facility | None | $77.62 | $134.90 | $158.49 |
United Setting Professional Modifier None Typical Low $44.67 Median $69.18 Typical High $102.33 | Professional | None | $44.67 | $69.18 | $102.33 |
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 $34.67 Median $41.69 Typical High $41.69 | Professional | 52 · Reduced service | $34.67 | $41.69 | $41.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $16.60 Typical High $16.60 | Professional | 53 · Discontinued | $13.80 | $16.60 | $16.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $12.59 Typical High $12.59 | Professional | 55 · Aftercare only | $10.47 | $12.59 | $12.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $8.32 Typical High $8.32 | Professional | 56 · Pre-op care only | $6.92 | $8.32 | $8.32 |
Where Arkansas sits
The same service costs 4.4 times more in Kansas than in Vermont. 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· 5th of 51
$129
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.