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 $107.15 Median $107.15 Typical High $107.15 | Facility | None | $107.15 | $107.15 | $107.15 |
Aetna Setting Professional Modifier None Typical Low $104.71 Median $107.15 Typical High $107.15 | Professional | None | $104.71 | $107.15 | $107.15 |
BCBS Arkansas Setting Professional Modifier None Typical Low $165.96 Median $186.21 Typical High $223.87 | Professional | None | $165.96 | $186.21 | $223.87 |
Cigna Setting Facility Modifier None Typical Low $107.15 Median $107.15 Typical High $158.49 | Facility | None | $107.15 | $107.15 | $158.49 |
Cigna Setting Professional Modifier None Typical Low $61.66 Median $79.43 Typical High $107.15 | Professional | None | $61.66 | $79.43 | $107.15 |
United Setting Facility Modifier None Typical Low $199.53 Median $234.42 Typical High $234.42 | Facility | None | $199.53 | $234.42 | $234.42 |
United Setting Professional Modifier None Typical Low $66.07 Median $91.20 Typical High $131.83 | Professional | None | $66.07 | $91.20 | $131.83 |
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 $52.48 Median $53.70 Typical High $53.70 | Professional | 52 · Reduced service | $52.48 | $53.70 | $53.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $21.38 Typical High $21.38 | Professional | 53 · Discontinued | $20.89 | $21.38 | $21.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $16.22 Typical High $16.22 | Professional | 55 · Aftercare only | $15.85 | $16.22 | $16.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $10.72 Typical High $10.72 | Professional | 56 · Pre-op care only | $10.47 | $10.72 | $10.72 |
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
$166
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.