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 $602.56 Median $602.56 Typical High $602.56 | Facility | None | $602.56 | $602.56 | $602.56 |
Aetna Setting Professional Modifier None Typical Low $426.58 Median $602.56 Typical High $602.56 | Professional | None | $426.58 | $602.56 | $602.56 |
Ambetter Setting Professional Modifier None Typical Low $630.96 Median $741.31 Typical High $741.31 | Professional | None | $630.96 | $741.31 | $741.31 |
BCBS Arkansas Setting Professional Modifier None Typical Low $616.60 Median $676.08 Typical High $812.83 | Professional | None | $616.60 | $676.08 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $707.95 | Facility | None | $630.96 | $630.96 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $630.96 | Professional | None | $467.74 | $467.74 | $630.96 |
Qualchoice Setting Professional Modifier None Typical Low $724.44 Median $851.14 Typical High $851.14 | Professional | None | $724.44 | $851.14 | $851.14 |
United Setting Facility Modifier None Typical Low $812.83 Median $954.99 Typical High $954.99 | Facility | None | $812.83 | $954.99 | $954.99 |
United Setting Professional Modifier None Typical Low $346.74 Median $524.81 Typical High $776.25 | Professional | None | $346.74 | $524.81 | $776.25 |
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 $223.87 Median $302.00 Typical High $302.00 | Professional | 52 · Reduced service | $223.87 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $120.23 Typical High $120.23 | Professional | 53 · Discontinued | $89.13 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $91.20 Typical High $91.20 | Professional | 55 · Aftercare only | $67.61 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $60.26 Typical High $60.26 | Professional | 56 · Pre-op care only | $44.67 | $60.26 | $60.26 |
Where Arkansas sits
The same service costs 2.2 times more in Kansas than in Utah. 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· 26th of 51
$617
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.