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 $141.25 Median $141.25 Typical High $141.25 | Facility | None | $141.25 | $141.25 | $141.25 |
Aetna Setting Professional Modifier None Typical Low $138.04 Median $141.25 Typical High $141.25 | Professional | None | $138.04 | $141.25 | $141.25 |
BCBS Setting Professional Modifier None Typical Low $218.78 Median $245.47 Typical High $295.12 | Professional | None | $218.78 | $245.47 | $295.12 |
Cigna Setting Facility Modifier None Typical Low $158.49 Median $158.49 Typical High $208.93 | Facility | None | $158.49 | $158.49 | $208.93 |
Cigna Setting Professional Modifier None Typical Low $91.20 Median $117.49 Typical High $158.49 | Professional | None | $91.20 | $117.49 | $158.49 |
United Setting Facility Modifier None Typical Low $141.25 Median $295.12 Typical High $346.74 | Facility | None | $141.25 | $295.12 | $346.74 |
United Setting Professional Modifier None Typical Low $97.72 Median $125.89 Typical High $194.98 | Professional | None | $97.72 | $125.89 | $194.98 |
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 $69.18 Median $70.79 Typical High $70.79 | Professional | 52 · Reduced service | $69.18 | $70.79 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $28.18 Typical High $28.18 | Professional | 53 · Discontinued | $27.54 | $28.18 | $28.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $21.38 Typical High $21.38 | Professional | 55 · Aftercare only | $20.89 | $21.38 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $14.13 Typical High $14.13 | Professional | 56 · Pre-op care only | $13.80 | $14.13 | $14.13 |
Where Arkansas sits
The same service costs 4.4 times more in Hawaii than in Kansas. 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
$219
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.