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 $154.88 Median $154.88 Typical High $154.88 | Facility | None | $154.88 | $154.88 | $154.88 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $154.88 Typical High $177.83 | Professional | None | $151.36 | $154.88 | $177.83 |
Ambetter Setting Professional Modifier None Typical Low $141.25 Median $162.18 Typical High $223.87 | Professional | None | $141.25 | $162.18 | $223.87 |
BCBS Arkansas Setting Professional Modifier None Typical Low $239.88 Median $263.03 Typical High $316.23 | Professional | None | $239.88 | $263.03 | $316.23 |
CareSource Setting Facility Modifier None Typical Low $275.42 Median $275.42 Typical High $275.42 | Facility | None | $275.42 | $275.42 | $275.42 |
CareSource Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $354.81 | Professional | None | $354.81 | $354.81 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $141.25 Median $141.25 Typical High $223.87 | Facility | None | $141.25 | $141.25 | $223.87 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $141.25 | Professional | None | $104.71 | $104.71 | $141.25 |
Qualchoice Setting Professional Modifier None Typical Low $186.21 Median $218.78 Typical High $257.04 | Professional | None | $186.21 | $218.78 | $257.04 |
United Setting Facility Modifier None Typical Low $281.84 Median $331.13 Typical High $331.13 | Facility | None | $281.84 | $331.13 | $331.13 |
United Setting Professional Modifier None Typical Low $95.50 Median $134.90 Typical High $213.80 | Professional | None | $95.50 | $134.90 | $213.80 |
6 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 $74.13 Median $75.86 Typical High $75.86 | Professional | 52 · Reduced service | $74.13 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $30.90 Typical High $30.90 | Professional | 53 · Discontinued | $29.51 | $30.90 | $30.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $22.91 Typical High $22.91 | Professional | 55 · Aftercare only | $22.39 | $22.91 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $15.49 Typical High $15.49 | Professional | 56 · Pre-op care only | $14.79 | $15.49 | $15.49 |
Ambetter Setting Professional Modifier EP · Child screening program Typical Low $223.87 Median $223.87 Typical High $223.87 | Professional | EP · Child screening program | $223.87 | $223.87 | $223.87 |
Qualchoice Setting Professional Modifier EP · Child screening program Typical Low $257.04 Median $257.04 Typical High $257.04 | Professional | EP · Child screening program | $257.04 | $257.04 | $257.04 |
Where Arkansas sits
The same service costs 2.2 times more in Hawaii 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· 14th of 51
$224
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.