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 $77.62 Median $77.62 Typical High $77.62 | Facility | None | $77.62 | $77.62 | $77.62 |
Aetna Setting Professional Modifier None Typical Low $69.18 Median $77.62 Typical High $77.62 | Professional | None | $69.18 | $77.62 | $77.62 |
BCBS Arkansas Setting Professional Modifier None Typical Low $120.23 Median $134.90 Typical High $162.18 | Professional | None | $120.23 | $134.90 | $162.18 |
Cigna Setting Facility Modifier None Typical Low $89.13 Median $89.13 Typical High $114.82 | Facility | None | $89.13 | $89.13 | $114.82 |
Cigna Setting Professional Modifier None Typical Low $50.12 Median $64.57 Typical High $89.13 | Professional | None | $50.12 | $64.57 | $89.13 |
United Setting Facility Modifier None Typical Low $70.79 Median $162.18 Typical High $190.55 | Facility | None | $70.79 | $162.18 | $190.55 |
United Setting Professional Modifier None Typical Low $53.70 Median $69.18 Typical High $107.15 | Professional | None | $53.70 | $69.18 | $107.15 |
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 $38.02 Median $38.90 Typical High $38.90 | Professional | 52 · Reduced service | $38.02 | $38.90 | $38.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $15.49 Typical High $15.49 | Professional | 53 · Discontinued | $15.14 | $15.49 | $15.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $11.75 Typical High $11.75 | Professional | 55 · Aftercare only | $11.48 | $11.75 | $11.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $7.76 Typical High $7.76 | Professional | 56 · Pre-op care only | $7.59 | $7.76 | $7.76 |
Where Arkansas sits
The same service costs 2.6 times more in Hawaii 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· 14th of 51
$120
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.