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 $109.65 Median $109.65 Typical High $109.65 | Facility | None | $109.65 | $109.65 | $109.65 |
Aetna Setting Professional Modifier None Typical Low $91.20 Median $109.65 Typical High $109.65 | Professional | None | $91.20 | $109.65 | $109.65 |
BCBS Setting Professional Modifier None Typical Low $169.82 Median $186.21 Typical High $223.87 | Professional | None | $169.82 | $186.21 | $223.87 |
Cigna Setting Facility Modifier None Typical Low $128.82 Median $128.82 Typical High $158.49 | Facility | None | $128.82 | $128.82 | $158.49 |
Cigna Setting Professional Modifier None Typical Low $61.66 Median $95.50 Typical High $128.82 | Professional | None | $61.66 | $95.50 | $128.82 |
United Setting Facility Modifier None Typical Low $199.53 Median $234.42 Typical High $234.42 | Facility | None | $199.53 | $234.42 | $234.42 |
United Setting Professional Modifier None Typical Low $66.07 Median $91.20 Typical High $134.90 | Professional | None | $66.07 | $91.20 | $134.90 |
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 $52.48 Median $54.95 Typical High $54.95 | Professional | 52 · Reduced service | $52.48 | $54.95 | $54.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $21.88 Typical High $21.88 | Professional | 53 · Discontinued | $21.38 | $21.88 | $21.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $16.22 Typical High $16.22 | Professional | 55 · Aftercare only | $15.85 | $16.22 | $16.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $10.96 Typical High $10.96 | Professional | 56 · Pre-op care only | $10.47 | $10.96 | $10.96 |
Where Arkansas sits
The same service costs 2.5 times more in Kansas than in New Jersey. 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
$170
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.