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 $75.86 Median $75.86 Typical High $75.86 | Facility | None | $75.86 | $75.86 | $75.86 |
Aetna Setting Professional Modifier None Typical Low $72.44 Median $75.86 Typical High $75.86 | Professional | None | $72.44 | $75.86 | $75.86 |
Ambetter Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | None | $109.65 | $109.65 | $109.65 |
BCBS Arkansas Setting Professional Modifier None Typical Low $117.49 Median $128.82 Typical High $154.88 | Professional | None | $117.49 | $128.82 | $154.88 |
Cigna Setting Facility Modifier None Typical Low $81.28 Median $87.10 Typical High $109.65 | Facility | None | $81.28 | $87.10 | $109.65 |
Cigna Setting Professional Modifier None Typical Low $47.86 Median $63.10 Typical High $87.10 | Professional | None | $47.86 | $63.10 | $87.10 |
Qualchoice Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
United Setting Facility Modifier None Typical Low $91.20 Median $154.88 Typical High $186.21 | Facility | None | $91.20 | $154.88 | $186.21 |
United Setting Professional Modifier None Typical Low $52.48 Median $67.61 Typical High $102.33 | Professional | None | $52.48 | $67.61 | $102.33 |
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 $36.31 Median $38.02 Typical High $38.02 | Professional | 52 · Reduced service | $36.31 | $38.02 | $38.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $15.14 Typical High $15.14 | Professional | 53 · Discontinued | $14.79 | $15.14 | $15.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $11.22 Typical High $11.22 | Professional | 55 · Aftercare only | $10.96 | $11.22 | $11.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $7.59 Typical High $7.59 | Professional | 56 · Pre-op care only | $7.24 | $7.59 | $7.59 |
Where Arkansas sits
The same service costs 5.0 times more in Hawaii than in Delaware. 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
$117
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.