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 $39.81 Median $39.81 Typical High $39.81 | Facility | None | $39.81 | $39.81 | $39.81 |
Aetna Setting Professional Modifier None Typical Low $30.20 Median $39.81 Typical High $39.81 | Professional | None | $30.20 | $39.81 | $39.81 |
BCBS Arkansas Setting Professional Modifier None Typical Low $61.66 Median $67.61 Typical High $81.28 | Professional | None | $61.66 | $67.61 | $81.28 |
Cigna Setting Facility Modifier None Typical Low $46.77 Median $46.77 Typical High $69.18 | Facility | None | $46.77 | $46.77 | $69.18 |
Cigna Setting Professional Modifier None Typical Low $23.44 Median $33.88 Typical High $46.77 | Professional | None | $23.44 | $33.88 | $46.77 |
United Setting Facility Modifier None Typical Low $43.65 Median $75.86 Typical High $89.13 | Facility | None | $43.65 | $75.86 | $89.13 |
United Setting Professional Modifier None Typical Low $25.12 Median $33.11 Typical High $48.98 | Professional | None | $25.12 | $33.11 | $48.98 |
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 $19.50 Median $19.95 Typical High $19.95 | Professional | 52 · Reduced service | $19.50 | $19.95 | $19.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.76 Median $7.94 Typical High $7.94 | Professional | 53 · Discontinued | $7.76 | $7.94 | $7.94 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.75 Median $6.03 Typical High $6.03 | Professional | 55 · Aftercare only | $5.75 | $6.03 | $6.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.89 Median $3.98 Typical High $3.98 | Professional | 56 · Pre-op care only | $3.89 | $3.98 | $3.98 |
Where Arkansas sits
The same service costs 3.1 times more in Hawaii than in Florida. 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· 12th of 51
$61.66
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.