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 $43.65 Median $43.65 Typical High $43.65 | Facility | None | $43.65 | $43.65 | $43.65 |
Aetna Setting Professional Modifier None Typical Low $34.67 Median $43.65 Typical High $43.65 | Professional | None | $34.67 | $43.65 | $43.65 |
BCBS Arkansas Setting Professional Modifier None Typical Low $67.61 Median $74.13 Typical High $89.13 | Professional | None | $67.61 | $74.13 | $89.13 |
Cigna Setting Facility Modifier None Typical Low $38.90 Median $38.90 Typical High $63.10 | Facility | None | $38.90 | $38.90 | $63.10 |
Cigna Setting Professional Modifier None Typical Low $20.89 Median $28.18 Typical High $38.90 | Professional | None | $20.89 | $28.18 | $38.90 |
United Setting Facility Modifier None Typical Low $35.48 Median $67.61 Typical High $79.43 | Facility | None | $35.48 | $67.61 | $79.43 |
United Setting Professional Modifier None Typical Low $22.39 Median $36.31 Typical High $52.48 | Professional | None | $22.39 | $36.31 | $52.48 |
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 $17.78 Median $21.38 Typical High $21.38 | Professional | 52 · Reduced service | $17.78 | $21.38 | $21.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.08 Median $8.71 Typical High $8.71 | Professional | 53 · Discontinued | $7.08 | $8.71 | $8.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.37 Median $6.46 Typical High $6.46 | Professional | 55 · Aftercare only | $5.37 | $6.46 | $6.46 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.55 Median $4.37 Typical High $4.37 | Professional | 56 · Pre-op care only | $3.55 | $4.37 | $4.37 |
Where Arkansas sits
The same service costs 3.0 times more in Hawaii than in Delaware. 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· 6th of 51
$67.61
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.