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 $263.03 Median $263.03 Typical High $263.03 | Facility | None | $263.03 | $263.03 | $263.03 |
Aetna Setting Professional Modifier None Typical Low $234.42 Median $263.03 Typical High $263.03 | Professional | None | $234.42 | $263.03 | $263.03 |
Ambetter Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $380.19 | Professional | None | $380.19 | $380.19 | $380.19 |
BCBS Arkansas Setting Professional Modifier None Typical Low $407.38 Median $446.68 Typical High $537.03 | Professional | None | $407.38 | $446.68 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $346.74 Median $346.74 Typical High $380.19 | Facility | None | $346.74 | $346.74 | $380.19 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $251.19 Typical High $346.74 | Professional | None | $158.49 | $251.19 | $346.74 |
Qualchoice Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $436.52 | Professional | None | $436.52 | $436.52 | $436.52 |
United Setting Facility Modifier None Typical Low $295.12 Median $512.86 Typical High $602.56 | Facility | None | $295.12 | $512.86 | $602.56 |
United Setting Professional Modifier None Typical Low $169.82 Median $218.78 Typical High $331.13 | Professional | None | $169.82 | $218.78 | $331.13 |
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 $125.89 Median $128.82 Typical High $128.82 | Professional | 52 · Reduced service | $125.89 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $52.48 Typical High $52.48 | Professional | 53 · Discontinued | $50.12 | $52.48 | $52.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $38.90 Typical High $38.90 | Professional | 55 · Aftercare only | $38.02 | $38.90 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $26.30 Typical High $26.30 | Professional | 56 · Pre-op care only | $25.12 | $26.30 | $26.30 |
Where Arkansas sits
The same service costs 3.8 times more in Hawaii than in Florida. 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
$407
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.