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 $17.38 Median $17.38 Typical High $17.38 | Facility | None | $17.38 | $17.38 | $17.38 |
Aetna Setting Professional Modifier None Typical Low $15.14 Median $17.38 Typical High $17.38 | Professional | None | $15.14 | $17.38 | $17.38 |
BCBS Arkansas Setting Professional Modifier None Typical Low $38.02 Median $41.69 Typical High $50.12 | Professional | None | $38.02 | $41.69 | $50.12 |
Cigna Setting Facility Modifier None Typical Low $27.54 Median $27.54 Typical High $27.54 | Facility | None | $27.54 | $27.54 | $27.54 |
Cigna Setting Professional Modifier None Typical Low $12.30 Median $19.95 Typical High $27.54 | Professional | None | $12.30 | $19.95 | $27.54 |
United Setting Professional Modifier None Typical Low $11.48 Median $17.38 Typical High $30.20 | Professional | None | $11.48 | $17.38 | $30.20 |
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 $7.59 Median $8.71 Typical High $8.71 | Professional | 52 · Reduced service | $7.59 | $8.71 | $8.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.02 Median $3.47 Typical High $3.47 | Professional | 53 · Discontinued | $3.02 | $3.47 | $3.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.29 Median $2.57 Typical High $2.57 | Professional | 55 · Aftercare only | $2.29 | $2.57 | $2.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.51 Median $1.74 Typical High $1.74 | Professional | 56 · Pre-op care only | $1.51 | $1.74 | $1.74 |
Where Arkansas sits
The same service costs 4.4 times more in Wyoming than in Colorado. 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· 5th of 51
$38.02
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.