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 $36.31 Median $36.31 Typical High $36.31 | Facility | None | $36.31 | $36.31 | $36.31 |
Aetna Setting Professional Modifier None Typical Low $30.20 Median $36.31 Typical High $43.65 | Professional | None | $30.20 | $36.31 | $43.65 |
Ambetter Setting Professional Modifier None Typical Low $25.12 Median $53.70 Typical High $53.70 | Professional | None | $25.12 | $53.70 | $53.70 |
BCBS Arkansas Setting Professional Modifier None Typical Low $57.54 Median $63.10 Typical High $75.86 | Professional | None | $57.54 | $63.10 | $75.86 |
CareSource Setting Facility Modifier None Typical Low $66.07 Median $66.07 Typical High $66.07 | Facility | None | $66.07 | $66.07 | $66.07 |
CareSource Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $85.11 | Professional | None | $85.11 | $85.11 | $85.11 |
Cigna Setting Facility Modifier None Typical Low $45.71 Median $45.71 Typical High $53.70 | Facility | None | $45.71 | $45.71 | $53.70 |
Cigna Setting Professional Modifier None Typical Low $23.44 Median $33.11 Typical High $45.71 | Professional | None | $23.44 | $33.11 | $45.71 |
Qualchoice Setting Professional Modifier None Typical Low $28.84 Median $61.66 Typical High $61.66 | Professional | None | $28.84 | $61.66 | $61.66 |
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 $32.36 Typical High $50.12 | Professional | None | $25.12 | $32.36 | $50.12 |
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 $17.78 Median $18.20 Typical High $18.20 | Professional | 52 · Reduced service | $17.78 | $18.20 | $18.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.08 Median $7.41 Typical High $7.41 | Professional | 53 · Discontinued | $7.08 | $7.41 | $7.41 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.37 Median $5.50 Typical High $5.50 | Professional | 55 · Aftercare only | $5.37 | $5.50 | $5.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.55 Median $3.63 Typical High $3.63 | Professional | 56 · Pre-op care only | $3.55 | $3.63 | $3.63 |
Where Arkansas sits
The same service costs 3.8 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· 18th of 51
$53.70
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.