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 $75.86 Median $75.86 Typical High $75.86 | Facility | None | $75.86 | $75.86 | $75.86 |
Aetna Setting Professional Modifier None Typical Low $63.10 Median $75.86 Typical High $75.86 | Professional | None | $63.10 | $75.86 | $75.86 |
BCBS Arkansas Setting Professional Modifier None Typical Low $117.49 Median $131.83 Typical High $158.49 | Professional | None | $117.49 | $131.83 | $158.49 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $66.07 Typical High $112.20 | Facility | None | $66.07 | $66.07 | $112.20 |
Cigna Setting Professional Modifier None Typical Low $37.15 Median $48.98 Typical High $66.07 | Professional | None | $37.15 | $48.98 | $66.07 |
United Setting Facility Modifier None Typical Low $61.66 Median $120.23 Typical High $141.25 | Facility | None | $61.66 | $120.23 | $141.25 |
United Setting Professional Modifier None Typical Low $39.81 Median $64.57 Typical High $93.33 | Professional | None | $39.81 | $64.57 | $93.33 |
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 $31.62 Median $38.02 Typical High $38.02 | Professional | 52 · Reduced service | $31.62 | $38.02 | $38.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $15.14 Typical High $15.14 | Professional | 53 · Discontinued | $12.88 | $15.14 | $15.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $11.48 Typical High $11.48 | Professional | 55 · Aftercare only | $9.55 | $11.48 | $11.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $7.59 Typical High $7.59 | Professional | 56 · Pre-op care only | $6.31 | $7.59 | $7.59 |
Where Arkansas sits
The same service costs 3.5 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· 6th of 51
$117
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.