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 $4.57 Median $4.57 Typical High $4.57 | Facility | None | $4.57 | $4.57 | $4.57 |
Aetna Setting Professional Modifier None Typical Low $4.57 Median $4.57 Typical High $4.57 | Professional | None | $4.57 | $4.57 | $4.57 |
BCBS Arkansas Setting Professional Modifier None Typical Low $10.00 Median $10.96 Typical High $13.18 | Professional | None | $10.00 | $10.96 | $13.18 |
Cigna Setting Facility Modifier None Typical Low $9.33 Median $9.33 Typical High $9.33 | Facility | None | $9.33 | $9.33 | $9.33 |
Cigna Setting Professional Modifier None Typical Low $6.76 Median $6.76 Typical High $9.33 | Professional | None | $6.76 | $6.76 | $9.33 |
United Setting Professional Modifier None Typical Low $4.07 Median $6.03 Typical High $10.96 | Professional | None | $4.07 | $6.03 | $10.96 |
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 $2.29 Median $2.29 Typical High $2.29 | Professional | 52 · Reduced service | $2.29 | $2.29 | $2.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.91 Median $0.91 Typical High $0.91 | Professional | 53 · Discontinued | $0.91 | $0.91 | $0.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.68 Median $0.68 Typical High $0.68 | Professional | 55 · Aftercare only | $0.68 | $0.68 | $0.68 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.45 Median $0.45 Typical High $0.45 | Professional | 56 · Pre-op care only | $0.45 | $0.45 | $0.45 |
Where Arkansas sits
The same service costs 39.8 times more in New York than in Hawaii. 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· 13th of 51
$10.00
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.