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 $81.28 Median $81.28 Typical High $81.28 | Facility | None | $81.28 | $81.28 | $81.28 |
Aetna Setting Professional Modifier None Typical Low $70.79 Median $81.28 Typical High $81.28 | Professional | None | $70.79 | $81.28 | $81.28 |
Ambetter Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | None | $120.23 | $120.23 | $120.23 |
BCBS Arkansas Setting Professional Modifier None Typical Low $125.89 Median $141.25 Typical High $169.82 | Professional | None | $125.89 | $141.25 | $169.82 |
CareSource Setting Facility Modifier None Typical Low $147.91 Median $147.91 Typical High $147.91 | Facility | None | $147.91 | $147.91 | $147.91 |
CareSource Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $190.55 | Professional | None | $190.55 | $190.55 | $190.55 |
Cigna Setting Facility Modifier None Typical Low $102.33 Median $102.33 Typical High $120.23 | Facility | None | $102.33 | $102.33 | $120.23 |
Cigna Setting Professional Modifier None Typical Low $50.12 Median $74.13 Typical High $102.33 | Professional | None | $50.12 | $74.13 | $102.33 |
Qualchoice Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | None | $138.04 | $138.04 | $138.04 |
United Setting Facility Modifier None Typical Low $87.10 Median $190.55 Typical High $190.55 | Facility | None | $87.10 | $190.55 | $190.55 |
United Setting Professional Modifier None Typical Low $53.70 Median $70.79 Typical High $107.15 | Professional | None | $53.70 | $70.79 | $107.15 |
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 $39.81 Median $40.74 Typical High $40.74 | Professional | 52 · Reduced service | $39.81 | $40.74 | $40.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $16.22 Typical High $16.22 | Professional | 53 · Discontinued | $15.85 | $16.22 | $16.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $12.30 Typical High $12.30 | Professional | 55 · Aftercare only | $12.02 | $12.30 | $12.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $8.13 Typical High $8.13 | Professional | 56 · Pre-op care only | $7.94 | $8.13 | $8.13 |
Where Arkansas sits
The same service costs 2.9 times more in Hawaii than in New Jersey. 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· 15th of 51
$126
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.