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 $257.04 Median $257.04 Typical High $257.04 | Facility | None | $257.04 | $257.04 | $257.04 |
Aetna Setting Professional Modifier None Typical Low $199.53 Median $257.04 Typical High $257.04 | Professional | None | $199.53 | $257.04 | $257.04 |
BCBS Arkansas Setting Professional Modifier None Typical Low $398.11 Median $436.52 Typical High $524.81 | Professional | None | $398.11 | $436.52 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $213.80 Median $213.80 Typical High $380.19 | Facility | None | $213.80 | $213.80 | $380.19 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $158.49 Typical High $213.80 | Professional | None | $123.03 | $158.49 | $213.80 |
United Setting Facility Modifier None Typical Low $229.09 Median $398.11 Typical High $467.74 | Facility | None | $229.09 | $398.11 | $467.74 |
United Setting Professional Modifier None Typical Low $131.83 Median $213.80 Typical High $309.03 | Professional | None | $131.83 | $213.80 | $309.03 |
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 $107.15 Median $128.82 Typical High $128.82 | Professional | 52 · Reduced service | $107.15 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $51.29 Typical High $51.29 | Professional | 53 · Discontinued | $42.66 | $51.29 | $51.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $38.02 Typical High $38.02 | Professional | 55 · Aftercare only | $32.36 | $38.02 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $25.70 Typical High $25.70 | Professional | 56 · Pre-op care only | $21.38 | $25.70 | $25.70 |
Where Arkansas sits
The same service costs 4.4 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· 3rd of 51
$398
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.