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 $354.81 Median $354.81 Typical High $354.81 | Facility | None | $354.81 | $354.81 | $354.81 |
Aetna Setting Professional Modifier None Typical Low $295.12 Median $354.81 Typical High $354.81 | Professional | None | $295.12 | $354.81 | $354.81 |
BCBS Arkansas Setting Professional Modifier None Typical Low $549.54 Median $616.60 Typical High $724.44 | Professional | None | $549.54 | $616.60 | $724.44 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $398.11 Typical High $524.81 | Facility | None | $398.11 | $398.11 | $524.81 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $295.12 Typical High $398.11 | Professional | None | $229.09 | $295.12 | $398.11 |
United Setting Facility Modifier None Typical Low $295.12 Median $741.31 Typical High $870.96 | Facility | None | $295.12 | $741.31 | $870.96 |
United Setting Professional Modifier None Typical Low $245.47 Median $316.23 Typical High $446.68 | Professional | None | $245.47 | $316.23 | $446.68 |
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 $173.78 Median $177.83 Typical High $177.83 | Professional | 52 · Reduced service | $173.78 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $70.79 Typical High $70.79 | Professional | 53 · Discontinued | $69.18 | $70.79 | $70.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $53.70 Typical High $53.70 | Professional | 55 · Aftercare only | $52.48 | $53.70 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $35.48 Typical High $35.48 | Professional | 56 · Pre-op care only | $34.67 | $35.48 | $35.48 |
Where Arkansas sits
The same service costs 3.0 times more in Montana 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· 13th of 51
$550
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.