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 $51.29 Median $51.29 Typical High $51.29 | Facility | None | $51.29 | $51.29 | $51.29 |
Aetna Setting Professional Modifier None Typical Low $50.12 Median $51.29 Typical High $51.29 | Professional | None | $50.12 | $51.29 | $51.29 |
BCBS Arkansas Setting Professional Modifier None Typical Low $79.43 Median $87.10 Typical High $104.71 | Professional | None | $79.43 | $87.10 | $104.71 |
Cigna Setting Facility Modifier None Typical Low $61.66 Median $61.66 Typical High $74.13 | Facility | None | $61.66 | $61.66 | $74.13 |
Cigna Setting Professional Modifier None Typical Low $28.84 Median $44.67 Typical High $61.66 | Professional | None | $28.84 | $44.67 | $61.66 |
United Setting Facility Modifier None Typical Low $41.69 Median $93.33 Typical High $109.65 | Facility | None | $41.69 | $93.33 | $109.65 |
United Setting Professional Modifier None Typical Low $31.62 Median $42.66 Typical High $63.10 | Professional | None | $31.62 | $42.66 | $63.10 |
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 $25.12 Median $25.70 Typical High $25.70 | Professional | 52 · Reduced service | $25.12 | $25.70 | $25.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.00 Median $10.23 Typical High $10.23 | Professional | 53 · Discontinued | $10.00 | $10.23 | $10.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.41 Median $7.59 Typical High $7.59 | Professional | 55 · Aftercare only | $7.41 | $7.59 | $7.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.01 Median $5.13 Typical High $5.13 | Professional | 56 · Pre-op care only | $5.01 | $5.13 | $5.13 |
Where Arkansas sits
The same service costs 2.5 times more in Hawaii than in Arizona. 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
$79.43
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.