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 $63.10 Median $63.10 Typical High $63.10 | Facility | None | $63.10 | $63.10 | $63.10 |
Aetna Setting Professional Modifier None Typical Low $53.70 Median $63.10 Typical High $63.10 | Professional | None | $53.70 | $63.10 | $63.10 |
BCBS Arkansas Setting Professional Modifier None Typical Low $97.72 Median $107.15 Typical High $128.82 | Professional | None | $97.72 | $107.15 | $128.82 |
Cigna Setting Facility Modifier None Typical Low $61.66 Median $61.66 Typical High $91.20 | Facility | None | $61.66 | $61.66 | $91.20 |
Cigna Setting Professional Modifier None Typical Low $35.48 Median $44.67 Typical High $61.66 | Professional | None | $35.48 | $44.67 | $61.66 |
United Setting Facility Modifier None Typical Low $29.51 Median $114.82 Typical High $134.90 | Facility | None | $29.51 | $114.82 | $134.90 |
United Setting Professional Modifier None Typical Low $38.02 Median $52.48 Typical High $77.62 | Professional | None | $38.02 | $52.48 | $77.62 |
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 $28.84 Median $31.62 Typical High $31.62 | Professional | 52 · Reduced service | $28.84 | $31.62 | $31.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $12.59 Typical High $12.59 | Professional | 53 · Discontinued | $11.48 | $12.59 | $12.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $9.33 Typical High $9.33 | Professional | 55 · Aftercare only | $8.51 | $9.33 | $9.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $6.31 Typical High $6.31 | Professional | 56 · Pre-op care only | $5.75 | $6.31 | $6.31 |
Where Arkansas sits
The same service costs 2.4 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· 8th of 51
$97.72
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.