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 $28.84 Median $28.84 Typical High $28.84 | Facility | None | $28.84 | $28.84 | $28.84 |
Aetna Setting Professional Modifier None Typical Low $23.99 Median $28.84 Typical High $28.84 | Professional | None | $23.99 | $28.84 | $28.84 |
BCBS Arkansas Setting Professional Modifier None Typical Low $45.71 Median $50.12 Typical High $60.26 | Professional | None | $45.71 | $50.12 | $60.26 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $34.67 Typical High $42.66 | Facility | None | $34.67 | $34.67 | $42.66 |
Cigna Setting Professional Modifier None Typical Low $16.60 Median $25.70 Typical High $34.67 | Professional | None | $16.60 | $25.70 | $34.67 |
United Setting Facility Modifier None Typical Low $53.70 Median $63.10 Typical High $63.10 | Facility | None | $53.70 | $63.10 | $63.10 |
United Setting Professional Modifier None Typical Low $17.78 Median $24.55 Typical High $35.48 | Professional | None | $17.78 | $24.55 | $35.48 |
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 $14.13 Median $14.45 Typical High $14.45 | Professional | 52 · Reduced service | $14.13 | $14.45 | $14.45 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.62 Median $5.75 Typical High $5.75 | Professional | 53 · Discontinued | $5.62 | $5.75 | $5.75 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.27 Median $4.37 Typical High $4.37 | Professional | 55 · Aftercare only | $4.27 | $4.37 | $4.37 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.82 Median $2.88 Typical High $2.88 | Professional | 56 · Pre-op care only | $2.82 | $2.88 | $2.88 |
Where Arkansas sits
The same service costs 2.1 times more in Montana 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· 10th of 51
$45.71
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.