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 $57.54 Median $57.54 Typical High $57.54 | Facility | None | $57.54 | $57.54 | $57.54 |
Aetna Setting Professional Modifier None Typical Low $56.23 Median $57.54 Typical High $57.54 | Professional | None | $56.23 | $57.54 | $57.54 |
BCBS Arkansas Setting Professional Modifier None Typical Low $89.13 Median $97.72 Typical High $117.49 | Professional | None | $89.13 | $97.72 | $117.49 |
Cigna Setting Facility Modifier None Typical Low $57.54 Median $57.54 Typical High $85.11 | Facility | None | $57.54 | $57.54 | $85.11 |
Cigna Setting Professional Modifier None Typical Low $32.36 Median $41.69 Typical High $57.54 | Professional | None | $32.36 | $41.69 | $57.54 |
United Setting Facility Modifier None Typical Low $107.15 Median $125.89 Typical High $125.89 | Facility | None | $107.15 | $125.89 | $125.89 |
United Setting Professional Modifier None Typical Low $35.48 Median $47.86 Typical High $70.79 | Professional | None | $35.48 | $47.86 | $70.79 |
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 $28.18 Median $28.84 Typical High $28.84 | Professional | 52 · Reduced service | $28.18 | $28.84 | $28.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.22 Median $11.48 Typical High $11.48 | Professional | 53 · Discontinued | $11.22 | $11.48 | $11.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $8.51 Typical High $8.51 | Professional | 55 · Aftercare only | $8.32 | $8.51 | $8.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $5.75 Typical High $5.75 | Professional | 56 · Pre-op care only | $5.62 | $5.75 | $5.75 |
Where Arkansas sits
The same service costs 2.6 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
$89.13
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.