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 $25.70 Median $25.70 Typical High $25.70 | Facility | None | $25.70 | $25.70 | $25.70 |
Aetna Setting Professional Modifier None Typical Low $21.38 Median $25.70 Typical High $25.70 | Professional | None | $21.38 | $25.70 | $25.70 |
BCBS Arkansas Setting Professional Modifier None Typical Low $39.81 Median $43.65 Typical High $52.48 | Professional | None | $39.81 | $43.65 | $52.48 |
Cigna Setting Facility Modifier None Typical Low $26.92 Median $26.92 Typical High $38.02 | Facility | None | $26.92 | $26.92 | $38.02 |
Cigna Setting Professional Modifier None Typical Low $14.79 Median $19.95 Typical High $26.92 | Professional | None | $14.79 | $19.95 | $26.92 |
United Setting Facility Modifier None Typical Low $47.86 Median $56.23 Typical High $56.23 | Facility | None | $47.86 | $56.23 | $56.23 |
United Setting Professional Modifier None Typical Low $15.85 Median $21.38 Typical High $31.62 | Professional | None | $15.85 | $21.38 | $31.62 |
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 $12.59 Median $12.88 Typical High $12.88 | Professional | 52 · Reduced service | $12.59 | $12.88 | $12.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.01 Median $5.13 Typical High $5.13 | Professional | 53 · Discontinued | $5.01 | $5.13 | $5.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.72 Median $3.89 Typical High $3.89 | Professional | 55 · Aftercare only | $3.72 | $3.89 | $3.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.51 Median $2.57 Typical High $2.57 | Professional | 56 · Pre-op care only | $2.51 | $2.57 | $2.57 |
Where Arkansas sits
The same service costs 2.5 times more in Montana than in Delaware. 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· 10th of 51
$39.81
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.