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 $87.10 Median $87.10 Typical High $87.10 | Facility | None | $87.10 | $87.10 | $87.10 |
Aetna Setting Professional Modifier None Typical Low $74.13 Median $87.10 Typical High $87.10 | Professional | None | $74.13 | $87.10 | $87.10 |
Ambetter Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $128.82 | Professional | None | $128.82 | $128.82 | $128.82 |
BCBS Arkansas Setting Professional Modifier None Typical Low $138.04 Median $151.36 Typical High $181.97 | Professional | None | $138.04 | $151.36 | $181.97 |
Cigna Setting Facility Modifier None Typical Low $89.13 Median $89.13 Typical High $128.82 | Facility | None | $89.13 | $89.13 | $128.82 |
Cigna Setting Professional Modifier None Typical Low $50.12 Median $64.57 Typical High $89.13 | Professional | None | $50.12 | $64.57 | $89.13 |
Qualchoice Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $147.91 | Professional | None | $147.91 | $147.91 | $147.91 |
United Setting Facility Modifier None Typical Low $77.62 Median $190.55 Typical High $190.55 | Facility | None | $77.62 | $190.55 | $190.55 |
United Setting Professional Modifier None Typical Low $53.70 Median $74.13 Typical High $107.15 | Professional | None | $53.70 | $74.13 | $107.15 |
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 $42.66 Median $43.65 Typical High $43.65 | Professional | 52 · Reduced service | $42.66 | $43.65 | $43.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $17.78 Typical High $17.78 | Professional | 53 · Discontinued | $16.98 | $17.78 | $17.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $13.18 Typical High $13.18 | Professional | 55 · Aftercare only | $12.88 | $13.18 | $13.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $8.71 Typical High $8.71 | Professional | 56 · Pre-op care only | $8.51 | $8.71 | $8.71 |
Where Arkansas sits
The same service costs 2.8 times more in Kansas 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· 11th of 51
$138
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.