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 $28.18 Median $33.11 Typical High $33.11 | Professional | None | $28.18 | $33.11 | $33.11 |
BCBS Arkansas Setting Professional Modifier None Typical Low $51.29 Median $57.54 Typical High $69.18 | Professional | None | $51.29 | $57.54 | $69.18 |
Cigna Setting Facility Modifier None Typical Low $33.11 Median $33.11 Typical High $48.98 | Facility | None | $33.11 | $33.11 | $48.98 |
Cigna Setting Professional Modifier None Typical Low $19.05 Median $24.55 Typical High $33.11 | Professional | None | $19.05 | $24.55 | $33.11 |
United Setting Facility Modifier None Typical Low $61.66 Median $72.44 Typical High $72.44 | Facility | None | $61.66 | $72.44 | $72.44 |
United Setting Professional Modifier None Typical Low $20.42 Median $28.18 Typical High $40.74 | Professional | None | $20.42 | $28.18 | $40.74 |
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 $16.22 Median $16.60 Typical High $16.60 | Professional | 52 · Reduced service | $16.22 | $16.60 | $16.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.46 Median $6.61 Typical High $6.61 | Professional | 53 · Discontinued | $6.46 | $6.61 | $6.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.90 Median $5.01 Typical High $5.01 | Professional | 55 · Aftercare only | $4.90 | $5.01 | $5.01 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.24 Median $3.31 Typical High $3.31 | Professional | 56 · Pre-op care only | $3.24 | $3.31 | $3.31 |
Where Arkansas sits
The same service costs 2.8 times more in Kansas 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· 11th of 51
$51.29
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.