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 $446.68 Median $446.68 Typical High $446.68 | Facility | None | $446.68 | $446.68 | $446.68 |
Aetna Setting Professional Modifier None Typical Low $426.58 Median $446.68 Typical High $446.68 | Professional | None | $426.58 | $446.68 | $446.68 |
Ambetter Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $660.69 | Professional | None | $660.69 | $660.69 | $660.69 |
BCBS Arkansas Setting Professional Modifier None Typical Low $691.83 Median $758.58 Typical High $912.01 | Professional | None | $691.83 | $758.58 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $660.69 | Facility | None | $549.54 | $549.54 | $660.69 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $398.11 Typical High $549.54 | Professional | None | $288.40 | $398.11 | $549.54 |
Qualchoice Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $758.58 | Professional | None | $758.58 | $758.58 | $758.58 |
United Setting Facility Modifier None Typical Low $331.13 Median $933.25 Typical High $1,096.48 | Facility | None | $331.13 | $933.25 | $1,096.48 |
United Setting Professional Modifier None Typical Low $309.03 Median $398.11 Typical High $588.84 | Professional | None | $309.03 | $398.11 | $588.84 |
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 $218.78 Median $223.87 Typical High $223.87 | Professional | 52 · Reduced service | $218.78 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $89.13 Typical High $89.13 | Professional | 53 · Discontinued | $87.10 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $67.61 Typical High $67.61 | Professional | 55 · Aftercare only | $64.57 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $44.67 Typical High $44.67 | Professional | 56 · Pre-op care only | $43.65 | $44.67 | $44.67 |
Where Arkansas sits
The same service costs 2.4 times more in Iowa 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· 16th of 51
$692
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.