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 $316.23 Median $316.23 Typical High $316.23 | Facility | None | $316.23 | $316.23 | $316.23 |
Aetna Setting Professional Modifier None Typical Low $263.03 Median $316.23 Typical High $316.23 | Professional | None | $263.03 | $316.23 | $316.23 |
Ambetter Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $467.74 | Professional | None | $467.74 | $467.74 | $467.74 |
BCBS Arkansas Setting Professional Modifier None Typical Low $489.78 Median $537.03 Typical High $645.65 | Professional | None | $489.78 | $537.03 | $645.65 |
Cigna Setting Facility Modifier None Typical Low $316.23 Median $316.23 Typical High $467.74 | Facility | None | $316.23 | $316.23 | $467.74 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $229.09 Typical High $316.23 | Professional | None | $181.97 | $229.09 | $316.23 |
Qualchoice Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $537.03 | Professional | None | $537.03 | $537.03 | $537.03 |
United Setting Facility Modifier None Typical Low $588.84 Median $691.83 Typical High $691.83 | Facility | None | $588.84 | $691.83 | $691.83 |
United Setting Professional Modifier None Typical Low $194.98 Median $263.03 Typical High $389.05 | Professional | None | $194.98 | $263.03 | $389.05 |
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 $154.88 Median $158.49 Typical High $158.49 | Professional | 52 · Reduced service | $154.88 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $63.10 Typical High $63.10 | Professional | 53 · Discontinued | $61.66 | $63.10 | $63.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $47.86 Typical High $47.86 | Professional | 55 · Aftercare only | $45.71 | $47.86 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $31.62 Typical High $31.62 | Professional | 56 · Pre-op care only | $30.90 | $31.62 | $31.62 |
Where Arkansas sits
The same service costs 2.6 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
$490
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.