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 $213.80 Median $213.80 Typical High $213.80 | Facility | None | $213.80 | $213.80 | $213.80 |
Aetna Setting Professional Modifier None Typical Low $177.83 Median $213.80 Typical High $213.80 | Professional | None | $177.83 | $213.80 | $213.80 |
Ambetter Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $309.03 | Professional | None | $309.03 | $309.03 | $309.03 |
BCBS Arkansas Setting Professional Modifier None Typical Low $331.13 Median $363.08 Typical High $436.52 | Professional | None | $331.13 | $363.08 | $436.52 |
CareSource Setting Facility Modifier None Typical Low $380.19 Median $380.19 Typical High $380.19 | Facility | None | $380.19 | $380.19 | $380.19 |
CareSource Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $489.78 | Professional | None | $489.78 | $489.78 | $489.78 |
Cigna Setting Facility Modifier None Typical Low $208.93 Median $208.93 Typical High $309.03 | Facility | None | $208.93 | $208.93 | $309.03 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $154.88 Typical High $208.93 | Professional | None | $120.23 | $154.88 | $208.93 |
Qualchoice Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $354.81 | Professional | None | $138.04 | $138.04 | $354.81 |
United Setting Facility Modifier None Typical Low $389.05 Median $457.09 Typical High $457.09 | Facility | None | $389.05 | $457.09 | $457.09 |
United Setting Professional Modifier None Typical Low $128.82 Median $177.83 Typical High $263.03 | Professional | None | $128.82 | $177.83 | $263.03 |
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 $102.33 Median $104.71 Typical High $104.71 | Professional | 52 · Reduced service | $102.33 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $42.66 Typical High $42.66 | Professional | 53 · Discontinued | $40.74 | $42.66 | $42.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $31.62 Typical High $31.62 | Professional | 55 · Aftercare only | $30.90 | $31.62 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $21.38 Typical High $21.38 | Professional | 56 · Pre-op care only | $20.42 | $21.38 | $21.38 |
Where Arkansas sits
The same service costs 2.4 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· 10th of 51
$331
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.