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 $7.94 Median $7.94 Typical High $7.94 | Facility | None | $7.94 | $7.94 | $7.94 |
Aetna Setting Professional Modifier None Typical Low $6.46 Median $7.94 Typical High $10.00 | Professional | None | $6.46 | $7.94 | $10.00 |
Ambetter Setting Professional Modifier None Typical Low $14.13 Median $19.95 Typical High $79.43 | Professional | None | $14.13 | $19.95 | $79.43 |
BCBS Arkansas Setting Professional Modifier None Typical Low $14.13 Median $15.49 Typical High $18.62 | Professional | None | $14.13 | $15.49 | $18.62 |
CareSource Setting Facility Modifier None Typical Low $10.23 Median $10.23 Typical High $10.23 | Facility | None | $10.23 | $10.23 | $10.23 |
CareSource Setting Professional Modifier None Typical Low $13.80 Median $13.80 Typical High $13.80 | Professional | None | $13.80 | $13.80 | $13.80 |
Cigna Setting Facility Modifier None Typical Low $20.89 Median $20.89 Typical High $21.38 | Facility | None | $20.89 | $20.89 | $21.38 |
Cigna Setting Professional Modifier None Typical Low $5.75 Median $15.49 Typical High $20.89 | Professional | None | $5.75 | $15.49 | $20.89 |
Qualchoice Setting Professional Modifier None Typical Low $8.32 Median $16.22 Typical High $22.91 | Professional | None | $8.32 | $16.22 | $22.91 |
United Setting Professional Modifier None Typical Low $5.37 Median $7.94 Typical High $13.80 | Professional | None | $5.37 | $7.94 | $13.80 |
6 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 $3.55 Median $3.98 Typical High $3.98 | Professional | 52 · Reduced service | $3.55 | $3.98 | $3.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.41 Median $1.58 Typical High $1.58 | Professional | 53 · Discontinued | $1.41 | $1.58 | $1.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.07 Median $1.20 Typical High $1.20 | Professional | 55 · Aftercare only | $1.07 | $1.20 | $1.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.71 Median $0.79 Typical High $0.79 | Professional | 56 · Pre-op care only | $0.71 | $0.79 | $0.79 |
Ambetter Setting Professional Modifier EP · Child screening program Typical Low $10.00 Median $10.00 Typical High $10.00 | Professional | EP · Child screening program | $10.00 | $10.00 | $10.00 |
Qualchoice Setting Professional Modifier EP · Child screening program Typical Low $11.48 Median $11.48 Typical High $11.48 | Professional | EP · Child screening program | $11.48 | $11.48 | $11.48 |
Where Arkansas sits
The same service costs 6.2 times more in Wyoming than in North Carolina. 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· 25th of 51
$14.13
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.