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 $134.90 Median $134.90 Typical High $134.90 | Facility | None | $134.90 | $134.90 | $134.90 |
Aetna Setting Professional Modifier None Typical Low $112.20 Median $134.90 Typical High $134.90 | Professional | None | $112.20 | $134.90 | $134.90 |
BCBS Arkansas Setting Professional Modifier None Typical Low $208.93 Median $229.09 Typical High $275.42 | Professional | None | $208.93 | $229.09 | $275.42 |
CareSource Setting Facility Modifier None Typical Low $239.88 Median $239.88 Typical High $239.88 | Facility | None | $239.88 | $239.88 | $239.88 |
CareSource Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $309.03 | Professional | None | $309.03 | $309.03 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $151.36 Median $151.36 Typical High $194.98 | Facility | None | $151.36 | $151.36 | $194.98 |
Cigna Setting Professional Modifier None Typical Low $75.86 Median $112.20 Typical High $151.36 | Professional | None | $75.86 | $112.20 | $151.36 |
United Setting Facility Modifier None Typical Low $245.47 Median $288.40 Typical High $288.40 | Facility | None | $245.47 | $288.40 | $288.40 |
United Setting Professional Modifier None Typical Low $81.28 Median $112.20 Typical High $165.96 | Professional | None | $81.28 | $112.20 | $165.96 |
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 $64.57 Median $66.07 Typical High $66.07 | Professional | 52 · Reduced service | $64.57 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $26.92 Typical High $26.92 | Professional | 53 · Discontinued | $25.70 | $26.92 | $26.92 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $19.95 Typical High $19.95 | Professional | 55 · Aftercare only | $19.50 | $19.95 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $13.49 Typical High $13.49 | Professional | 56 · Pre-op care only | $12.88 | $13.49 | $13.49 |
Where Arkansas sits
The same service costs 2.1 times more in Hawaii than in Utah. 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
$209
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.