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 $38.02 Median $38.02 Typical High $38.02 | Facility | None | $38.02 | $38.02 | $38.02 |
Aetna Setting Professional Modifier None Typical Low $31.62 Median $38.02 Typical High $38.02 | Professional | None | $31.62 | $38.02 | $38.02 |
BCBS Arkansas Setting Professional Modifier None Typical Low $58.88 Median $64.57 Typical High $77.62 | Professional | None | $58.88 | $64.57 | $77.62 |
Cigna Setting Facility Modifier None Typical Low $36.31 Median $36.31 Typical High $56.23 | Facility | None | $36.31 | $36.31 | $56.23 |
Cigna Setting Professional Modifier None Typical Low $23.99 Median $26.92 Typical High $36.31 | Professional | None | $23.99 | $26.92 | $36.31 |
United Setting Facility Modifier None Typical Low $38.90 Median $91.20 Typical High $91.20 | Facility | None | $38.90 | $91.20 | $91.20 |
United Setting Professional Modifier None Typical Low $25.70 Median $33.11 Typical High $51.29 | Professional | None | $25.70 | $33.11 | $51.29 |
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 $18.62 Median $19.05 Typical High $19.05 | Professional | 52 · Reduced service | $18.62 | $19.05 | $19.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.41 Median $7.59 Typical High $7.59 | Professional | 53 · Discontinued | $7.41 | $7.59 | $7.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.50 Median $5.75 Typical High $5.75 | Professional | 55 · Aftercare only | $5.50 | $5.75 | $5.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.72 Median $3.80 Typical High $3.80 | Professional | 56 · Pre-op care only | $3.72 | $3.80 | $3.80 |
Where Arkansas sits
The same service costs 2.9 times more in Hawaii 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· 15th of 51
$58.88
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.