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 $131.83 Median $131.83 Typical High $131.83 | Facility | None | $131.83 | $131.83 | $131.83 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $131.83 Typical High $131.83 | Professional | None | $107.15 | $131.83 | $131.83 |
BCBS Arkansas Setting Professional Modifier None Typical Low $204.17 Median $223.87 Typical High $269.15 | Professional | None | $204.17 | $223.87 | $269.15 |
Cigna Setting Facility Modifier None Typical Low $109.65 Median $109.65 Typical High $190.55 | Facility | None | $109.65 | $109.65 | $190.55 |
Cigna Setting Professional Modifier None Typical Low $63.10 Median $81.28 Typical High $109.65 | Professional | None | $63.10 | $81.28 | $109.65 |
United Setting Facility Modifier None Typical Low $89.13 Median $204.17 Typical High $239.88 | Facility | None | $89.13 | $204.17 | $239.88 |
United Setting Professional Modifier None Typical Low $67.61 Median $109.65 Typical High $158.49 | Professional | None | $67.61 | $109.65 | $158.49 |
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 $54.95 Median $66.07 Typical High $66.07 | Professional | 52 · Reduced service | $54.95 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $26.30 Typical High $26.30 | Professional | 53 · Discontinued | $21.88 | $26.30 | $26.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $19.50 Typical High $19.50 | Professional | 55 · Aftercare only | $16.22 | $19.50 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $13.18 Typical High $13.18 | Professional | 56 · Pre-op care only | $10.96 | $13.18 | $13.18 |
Where Arkansas sits
The same service costs 3.0 times more in Montana 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
$204
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.