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 $380.19 Median $380.19 Typical High $380.19 | Facility | None | $380.19 | $380.19 | $380.19 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $380.19 Typical High $380.19 | Professional | None | $316.23 | $380.19 | $380.19 |
Ambetter Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $562.34 | Professional | None | $562.34 | $562.34 | $562.34 |
BCBS Arkansas Setting Professional Modifier None Typical Low $588.84 Median $645.65 Typical High $776.25 | Professional | None | $588.84 | $645.65 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $416.87 Median $416.87 Typical High $562.34 | Facility | None | $416.87 | $416.87 | $562.34 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $309.03 Typical High $416.87 | Professional | None | $213.80 | $309.03 | $416.87 |
Qualchoice Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $645.65 | Professional | None | $645.65 | $645.65 | $645.65 |
United Setting Facility Modifier None Typical Low $707.95 Median $831.76 Typical High $831.76 | Facility | None | $707.95 | $831.76 | $831.76 |
United Setting Professional Modifier None Typical Low $234.42 Median $316.23 Typical High $467.74 | Professional | None | $234.42 | $316.23 | $467.74 |
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 $186.21 Median $190.55 Typical High $190.55 | Professional | 52 · Reduced service | $186.21 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $75.86 Typical High $75.86 | Professional | 53 · Discontinued | $74.13 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $56.23 Typical High $56.23 | Professional | 55 · Aftercare only | $54.95 | $56.23 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $38.02 Typical High $38.02 | Professional | 56 · Pre-op care only | $37.15 | $38.02 | $38.02 |
Where Arkansas sits
The same service costs 2.2 times more in Montana 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· 10th of 51
$589
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.