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 $64.57 Median $64.57 Typical High $64.57 | Facility | None | $64.57 | $64.57 | $64.57 |
Aetna Setting Professional Modifier None Typical Low $63.10 Median $64.57 Typical High $64.57 | Professional | None | $63.10 | $64.57 | $64.57 |
BCBS Arkansas Setting Professional Modifier None Typical Low $100.00 Median $109.65 Typical High $131.83 | Professional | None | $100.00 | $109.65 | $131.83 |
Cigna Setting Facility Modifier None Typical Low $70.79 Median $70.79 Typical High $95.50 | Facility | None | $70.79 | $70.79 | $95.50 |
Cigna Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $70.79 | Professional | None | $51.29 | $51.29 | $70.79 |
United Setting Facility Modifier None Typical Low $57.54 Median $120.23 Typical High $141.25 | Facility | None | $57.54 | $120.23 | $141.25 |
United Setting Professional Modifier None Typical Low $40.74 Median $56.23 Typical High $91.20 | Professional | None | $40.74 | $56.23 | $91.20 |
3 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 $32.36 Typical High $32.36 | Professional | 52 · Reduced service | $31.62 | $32.36 | $32.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $9.77 Typical High $9.77 | Professional | 55 · Aftercare only | $9.33 | $9.77 | $9.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $6.46 Typical High $6.46 | Professional | 56 · Pre-op care only | $6.31 | $6.46 | $6.46 |
Where Arkansas sits
The same service costs 2.4 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· 10th of 51
$100
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.