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 $128.82 Median $128.82 Typical High $128.82 | Facility | None | $128.82 | $128.82 | $128.82 |
Aetna Setting Professional Modifier None Typical Low $120.23 Median $128.82 Typical High $128.82 | Professional | None | $120.23 | $128.82 | $128.82 |
BCBS Arkansas Setting Professional Modifier None Typical Low $199.53 Median $223.87 Typical High $269.15 | Professional | None | $199.53 | $223.87 | $269.15 |
Cigna Setting Facility Modifier None Typical Low $141.25 Median $141.25 Typical High $190.55 | Facility | None | $141.25 | $141.25 | $190.55 |
Cigna Setting Professional Modifier None Typical Low $81.28 Median $102.33 Typical High $141.25 | Professional | None | $81.28 | $102.33 | $141.25 |
United Setting Facility Modifier None Typical Low $151.36 Median $309.03 Typical High $389.05 | Facility | None | $151.36 | $309.03 | $389.05 |
United Setting Professional Modifier None Typical Low $87.10 Median $112.20 Typical High $169.82 | Professional | None | $87.10 | $112.20 | $169.82 |
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 $61.66 Median $64.57 Typical High $64.57 | Professional | 52 · Reduced service | $61.66 | $64.57 | $64.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $25.70 Typical High $25.70 | Professional | 53 · Discontinued | $25.12 | $25.70 | $25.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $19.50 Typical High $19.50 | Professional | 55 · Aftercare only | $18.62 | $19.50 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $12.88 Typical High $12.88 | Professional | 56 · Pre-op care only | $12.30 | $12.88 | $12.88 |
Where Arkansas sits
The same service costs 8.1 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· 10th of 51
$200
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.