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 $14.13 Median $14.13 Typical High $14.13 | Facility | None | $14.13 | $14.13 | $14.13 |
Aetna Setting Professional Modifier None Typical Low $12.30 Median $14.13 Typical High $14.13 | Professional | None | $12.30 | $14.13 | $14.13 |
BCBS Arkansas Setting Professional Modifier None Typical Low $31.62 Median $34.67 Typical High $41.69 | Professional | None | $31.62 | $34.67 | $41.69 |
Cigna Setting Facility Modifier None Typical Low $28.18 Median $28.18 Typical High $28.18 | Facility | None | $28.18 | $28.18 | $28.18 |
Cigna Setting Professional Modifier None Typical Low $10.00 Median $20.42 Typical High $28.18 | Professional | None | $10.00 | $20.42 | $28.18 |
United Setting Professional Modifier None Typical Low $9.33 Median $14.13 Typical High $24.55 | Professional | None | $9.33 | $14.13 | $24.55 |
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 $6.17 Median $7.08 Typical High $7.08 | Professional | 52 · Reduced service | $6.17 | $7.08 | $7.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.45 Median $2.82 Typical High $2.82 | Professional | 53 · Discontinued | $2.45 | $2.82 | $2.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.86 Median $2.09 Typical High $2.09 | Professional | 55 · Aftercare only | $1.86 | $2.09 | $2.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.23 Median $1.41 Typical High $1.41 | Professional | 56 · Pre-op care only | $1.23 | $1.41 | $1.41 |
Where Arkansas sits
The same service costs 8.7 times more in Hawaii than in Kansas. 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· 6th of 51
$31.62
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.