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 $288.40 Median $288.40 Typical High $288.40 | Facility | None | $288.40 | $288.40 | $288.40 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $288.40 Typical High $288.40 | Professional | None | $281.84 | $288.40 | $288.40 |
BCBS Arkansas Setting Professional Modifier None Typical Low $457.09 Median $501.19 Typical High $602.56 | Professional | None | $457.09 | $501.19 | $602.56 |
Cigna Setting Facility Modifier None Typical Low $389.05 Median $389.05 Typical High $426.58 | Facility | None | $389.05 | $389.05 | $426.58 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $281.84 Typical High $389.05 | Professional | None | $177.83 | $281.84 | $389.05 |
United Setting Facility Modifier None Typical Low $331.13 Median $575.44 Typical High $676.08 | Facility | None | $331.13 | $575.44 | $676.08 |
United Setting Professional Modifier None Typical Low $190.55 Median $245.47 Typical High $371.54 | Professional | None | $190.55 | $245.47 | $371.54 |
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 $141.25 Median $144.54 Typical High $144.54 | Professional | 52 · Reduced service | $141.25 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $58.88 Typical High $58.88 | Professional | 53 · Discontinued | $56.23 | $58.88 | $58.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $43.65 Typical High $43.65 | Professional | 55 · Aftercare only | $42.66 | $43.65 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $28.84 Typical High $28.84 | Professional | 56 · Pre-op care only | $28.18 | $28.84 | $28.84 |
Where Arkansas sits
The same service costs 3.4 times more in Hawaii than in Washington, DC. 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· 14th of 51
$457
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.