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 $281.84 Median $281.84 Typical High $281.84 | Facility | None | $281.84 | $281.84 | $281.84 |
Aetna Setting Professional Modifier None Typical Low $269.15 Median $281.84 Typical High $281.84 | Professional | None | $269.15 | $281.84 | $281.84 |
Ambetter Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $416.87 | Professional | None | $416.87 | $416.87 | $416.87 |
BCBS Arkansas Setting Professional Modifier None Typical Low $436.52 Median $489.78 Typical High $588.84 | Professional | None | $436.52 | $489.78 | $588.84 |
Cigna Setting Facility Modifier None Typical Low $363.08 Median $363.08 Typical High $416.87 | Facility | None | $363.08 | $363.08 | $416.87 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $263.03 Typical High $363.08 | Professional | None | $181.97 | $263.03 | $363.08 |
Qualchoice Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $478.63 | Professional | None | $478.63 | $478.63 | $478.63 |
United Setting Facility Modifier None Typical Low $338.84 Median $588.84 Typical High $691.83 | Facility | None | $338.84 | $588.84 | $691.83 |
United Setting Professional Modifier None Typical Low $194.98 Median $251.19 Typical High $389.05 | Professional | None | $194.98 | $251.19 | $389.05 |
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 $138.04 Median $141.25 Typical High $141.25 | Professional | 52 · Reduced service | $138.04 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $56.23 Typical High $56.23 | Professional | 53 · Discontinued | $54.95 | $56.23 | $56.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $42.66 Typical High $42.66 | Professional | 55 · Aftercare only | $41.69 | $42.66 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $28.18 Typical High $28.18 | Professional | 56 · Pre-op care only | $27.54 | $28.18 | $28.18 |
Where Arkansas sits
The same service costs 3.3 times more in Hawaii than in West Virginia. 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· 14th of 51
$437
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.