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 $33.11 Median $33.11 Typical High $33.11 | Facility | None | $33.11 | $33.11 | $33.11 |
Aetna Setting Professional Modifier None Typical Low $28.84 Median $33.11 Typical High $33.11 | Professional | None | $28.84 | $33.11 | $33.11 |
BCBS Arkansas Setting Professional Modifier None Typical Low $50.12 Median $56.23 Typical High $66.07 | Professional | None | $50.12 | $56.23 | $66.07 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Facility | None | $50.12 | $50.12 | $50.12 |
Cigna Setting Professional Modifier None Typical Low $23.44 Median $36.31 Typical High $50.12 | Professional | None | $23.44 | $36.31 | $50.12 |
United Setting Professional Modifier None Typical Low $21.88 Median $33.11 Typical High $57.54 | Professional | None | $21.88 | $33.11 | $57.54 |
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 $14.45 Median $16.60 Typical High $16.60 | Professional | 52 · Reduced service | $14.45 | $16.60 | $16.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.75 Median $6.61 Typical High $6.61 | Professional | 53 · Discontinued | $5.75 | $6.61 | $6.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.37 Median $4.90 Typical High $4.90 | Professional | 55 · Aftercare only | $4.37 | $4.90 | $4.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.88 Median $3.31 Typical High $3.31 | Professional | 56 · Pre-op care only | $2.88 | $3.31 | $3.31 |
Where Arkansas sits
The same service costs 4.1 times more in Kansas 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· 21st of 51
$50.12
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.