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 $54.95 Median $54.95 Typical High $54.95 | Facility | None | $54.95 | $54.95 | $54.95 |
Aetna Setting Professional Modifier None Typical Low $48.98 Median $54.95 Typical High $54.95 | Professional | None | $48.98 | $54.95 | $54.95 |
Ambetter Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $79.43 | Professional | None | $79.43 | $79.43 | $79.43 |
BCBS Arkansas Setting Professional Modifier None Typical Low $85.11 Median $93.33 Typical High $112.20 | Professional | None | $85.11 | $93.33 | $112.20 |
Cigna Setting Facility Modifier None Typical Low $63.10 Median $63.10 Typical High $79.43 | Facility | None | $63.10 | $63.10 | $79.43 |
Cigna Setting Professional Modifier None Typical Low $33.11 Median $45.71 Typical High $63.10 | Professional | None | $33.11 | $45.71 | $63.10 |
Qualchoice Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $93.33 | Professional | None | $93.33 | $93.33 | $93.33 |
United Setting Facility Modifier None Typical Low $61.66 Median $107.15 Typical High $125.89 | Facility | None | $61.66 | $107.15 | $125.89 |
United Setting Professional Modifier None Typical Low $35.48 Median $45.71 Typical High $69.18 | Professional | None | $35.48 | $45.71 | $69.18 |
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 $26.30 Median $27.54 Typical High $27.54 | Professional | 52 · Reduced service | $26.30 | $27.54 | $27.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.47 Median $10.96 Typical High $10.96 | Professional | 53 · Discontinued | $10.47 | $10.96 | $10.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.76 Median $8.13 Typical High $8.13 | Professional | 55 · Aftercare only | $7.76 | $8.13 | $8.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.25 Median $5.50 Typical High $5.50 | Professional | 56 · Pre-op care only | $5.25 | $5.50 | $5.50 |
Where Arkansas sits
The same service costs 4.3 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· 13th of 51
$85.11
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.