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 $33.88 Median $33.88 Typical High $33.88 | Facility | None | $33.88 | $33.88 | $33.88 |
Aetna Setting Professional Modifier None Typical Low $32.36 Median $33.88 Typical High $33.88 | Professional | None | $32.36 | $33.88 | $33.88 |
BCBS Arkansas Setting Professional Modifier None Typical Low $52.48 Median $57.54 Typical High $69.18 | Professional | None | $52.48 | $57.54 | $69.18 |
Cigna Setting Facility Modifier None Typical Low $48.98 Median $48.98 Typical High $48.98 | Facility | None | $48.98 | $48.98 | $48.98 |
Cigna Setting Professional Modifier None Typical Low $21.38 Median $35.48 Typical High $48.98 | Professional | None | $21.38 | $35.48 | $48.98 |
United Setting Facility Modifier None Typical Low $40.74 Median $69.18 Typical High $83.18 | Facility | None | $40.74 | $69.18 | $83.18 |
United Setting Professional Modifier None Typical Low $23.44 Median $30.20 Typical High $45.71 | Professional | None | $23.44 | $30.20 | $45.71 |
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 $16.22 Median $16.98 Typical High $16.98 | Professional | 52 · Reduced service | $16.22 | $16.98 | $16.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.61 Median $6.76 Typical High $6.76 | Professional | 53 · Discontinued | $6.61 | $6.76 | $6.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.90 Median $5.01 Typical High $5.01 | Professional | 55 · Aftercare only | $4.90 | $5.01 | $5.01 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.24 Median $3.39 Typical High $3.39 | Professional | 56 · Pre-op care only | $3.24 | $3.39 | $3.39 |
Where Arkansas sits
The same service costs 4.0 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· 16th of 51
$52.48
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.