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 $199.53 Median $199.53 Typical High $199.53 | Facility | None | $199.53 | $199.53 | $199.53 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $199.53 Typical High $199.53 | Professional | None | $123.03 | $199.53 | $199.53 |
Ambetter Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $288.40 | Professional | None | $288.40 | $288.40 | $288.40 |
BCBS Arkansas Setting Professional Modifier None Typical Low $309.03 Median $338.84 Typical High $407.38 | Professional | None | $309.03 | $338.84 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $177.83 Median $177.83 Typical High $288.40 | Facility | None | $177.83 | $177.83 | $288.40 |
Cigna Setting Professional Modifier None Typical Low $95.50 Median $128.82 Typical High $177.83 | Professional | None | $95.50 | $128.82 | $177.83 |
Qualchoice Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $331.13 | Professional | None | $331.13 | $331.13 | $331.13 |
United Setting Facility Modifier None Typical Low $177.83 Median $309.03 Typical High $363.08 | Facility | None | $177.83 | $309.03 | $363.08 |
United Setting Professional Modifier None Typical Low $102.33 Median $165.96 Typical High $239.88 | Professional | None | $102.33 | $165.96 | $239.88 |
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 $85.11 Median $97.72 Typical High $97.72 | Professional | 52 · Reduced service | $85.11 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $39.81 Typical High $39.81 | Professional | 53 · Discontinued | $33.88 | $39.81 | $39.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $29.51 Typical High $29.51 | Professional | 55 · Aftercare only | $25.70 | $29.51 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $19.95 Typical High $19.95 | Professional | 56 · Pre-op care only | $16.98 | $19.95 | $19.95 |
Where Arkansas sits
The same service costs 3.5 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· 4th of 51
$309
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.