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 $162.18 Median $162.18 Typical High $162.18 | Facility | None | $162.18 | $162.18 | $162.18 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $162.18 Typical High $162.18 | Professional | None | $158.49 | $162.18 | $162.18 |
BCBS Arkansas Setting Professional Modifier None Typical Low $257.04 Median $281.84 Typical High $338.84 | Professional | None | $257.04 | $281.84 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $190.55 Median $190.55 Typical High $239.88 | Facility | None | $190.55 | $190.55 | $239.88 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $138.04 Typical High $190.55 | Professional | None | $104.71 | $138.04 | $190.55 |
United Setting Facility Modifier None Typical Low $190.55 Median $338.84 Typical High $398.11 | Facility | None | $190.55 | $338.84 | $398.11 |
United Setting Professional Modifier None Typical Low $112.20 Median $144.54 Typical High $223.87 | Professional | None | $112.20 | $144.54 | $223.87 |
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 $79.43 Median $81.28 Typical High $81.28 | Professional | 52 · Reduced service | $79.43 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $33.11 Typical High $33.11 | Professional | 53 · Discontinued | $31.62 | $33.11 | $33.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $24.55 Typical High $24.55 | Professional | 55 · Aftercare only | $23.99 | $24.55 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $16.22 Typical High $16.22 | Professional | 56 · Pre-op care only | $15.85 | $16.22 | $16.22 |
Where Arkansas sits
The same service costs 3.5 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· 10th of 51
$257
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.