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 $41.69 Median $41.69 Typical High $41.69 | Facility | None | $41.69 | $41.69 | $41.69 |
Aetna Setting Professional Modifier None Typical Low $40.74 Median $41.69 Typical High $41.69 | Professional | None | $40.74 | $41.69 | $41.69 |
BCBS Arkansas Setting Professional Modifier None Typical Low $64.57 Median $72.44 Typical High $87.10 | Professional | None | $64.57 | $72.44 | $87.10 |
Cigna Setting Facility Modifier None Typical Low $41.69 Median $41.69 Typical High $61.66 | Facility | None | $41.69 | $41.69 | $61.66 |
Cigna Setting Professional Modifier None Typical Low $23.99 Median $30.90 Typical High $41.69 | Professional | None | $23.99 | $30.90 | $41.69 |
United Setting Facility Modifier None Typical Low $77.62 Median $91.20 Typical High $91.20 | Facility | None | $77.62 | $91.20 | $91.20 |
United Setting Professional Modifier None Typical Low $25.70 Median $35.48 Typical High $51.29 | Professional | None | $25.70 | $35.48 | $51.29 |
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 $20.42 Median $20.89 Typical High $20.89 | Professional | 52 · Reduced service | $20.42 | $20.89 | $20.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.13 Median $8.32 Typical High $8.32 | Professional | 53 · Discontinued | $8.13 | $8.32 | $8.32 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.17 Median $6.31 Typical High $6.31 | Professional | 55 · Aftercare only | $6.17 | $6.31 | $6.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.07 Median $4.17 Typical High $4.17 | Professional | 56 · Pre-op care only | $4.07 | $4.17 | $4.17 |
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· 11th of 51
$64.57
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.