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 $89.13 Median $89.13 Typical High $89.13 | Facility | None | $89.13 | $89.13 | $89.13 |
Aetna Setting Professional Modifier None Typical Low $70.79 Median $89.13 Typical High $95.50 | Professional | None | $70.79 | $89.13 | $95.50 |
Ambetter Setting Professional Modifier None Typical Low $112.20 Median $131.83 Typical High $131.83 | Professional | None | $112.20 | $131.83 | $131.83 |
BCBS Arkansas Setting Professional Modifier None Typical Low $141.25 Median $154.88 Typical High $186.21 | Professional | None | $141.25 | $154.88 | $186.21 |
CareSource Setting Facility Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Facility | None | $144.54 | $144.54 | $144.54 |
CareSource Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $190.55 | Professional | None | $190.55 | $190.55 | $190.55 |
Cigna Setting Facility Modifier None Typical Low $95.50 Median $97.72 Typical High $131.83 | Facility | None | $95.50 | $97.72 | $131.83 |
Cigna Setting Professional Modifier None Typical Low $52.48 Median $70.79 Typical High $97.72 | Professional | None | $52.48 | $70.79 | $97.72 |
Qualchoice Setting Professional Modifier None Typical Low $128.82 Median $151.36 Typical High $151.36 | Professional | None | $128.82 | $151.36 | $151.36 |
United Setting Facility Modifier None Typical Low $79.43 Median $169.82 Typical High $199.53 | Facility | None | $79.43 | $169.82 | $199.53 |
United Setting Professional Modifier None Typical Low $56.23 Median $75.86 Typical High $109.65 | Professional | None | $56.23 | $75.86 | $109.65 |
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 $40.74 Median $44.67 Typical High $44.67 | Professional | 52 · Reduced service | $40.74 | $44.67 | $44.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $18.20 Typical High $18.20 | Professional | 53 · Discontinued | $16.60 | $18.20 | $18.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $13.49 Typical High $13.49 | Professional | 55 · Aftercare only | $12.30 | $13.49 | $13.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $8.91 Typical High $8.91 | Professional | 56 · Pre-op care only | $8.32 | $8.91 | $8.91 |
Where Arkansas sits
The same service costs 2.8 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· 11th of 51
$141
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.