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 $27.54 Median $27.54 Typical High $27.54 | Facility | None | $27.54 | $27.54 | $27.54 |
Aetna Setting Professional Modifier None Typical Low $22.39 Median $27.54 Typical High $27.54 | Professional | None | $22.39 | $27.54 | $27.54 |
BCBS Arkansas Setting Professional Modifier None Typical Low $42.66 Median $46.77 Typical High $56.23 | Professional | None | $42.66 | $46.77 | $56.23 |
Cigna Setting Facility Modifier None Typical Low $33.88 Median $33.88 Typical High $39.81 | Facility | None | $33.88 | $33.88 | $39.81 |
Cigna Setting Professional Modifier None Typical Low $15.49 Median $24.55 Typical High $33.88 | Professional | None | $15.49 | $24.55 | $33.88 |
United Setting Facility Modifier None Typical Low $50.12 Median $60.26 Typical High $60.26 | Facility | None | $50.12 | $60.26 | $60.26 |
United Setting Professional Modifier None Typical Low $16.98 Median $22.91 Typical High $33.88 | Professional | None | $16.98 | $22.91 | $33.88 |
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 $13.18 Median $13.80 Typical High $13.80 | Professional | 52 · Reduced service | $13.18 | $13.80 | $13.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.37 Median $5.50 Typical High $5.50 | Professional | 53 · Discontinued | $5.37 | $5.50 | $5.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.98 Median $4.07 Typical High $4.07 | Professional | 55 · Aftercare only | $3.98 | $4.07 | $4.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.69 Median $2.75 Typical High $2.75 | Professional | 56 · Pre-op care only | $2.69 | $2.75 | $2.75 |
Where Arkansas sits
The same service costs 3.1 times more in Montana 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· 10th of 51
$42.66
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.