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 $53.70 Median $53.70 Typical High $53.70 | Facility | None | $53.70 | $53.70 | $53.70 |
Aetna Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $66.07 | Professional | None | $53.70 | $53.70 | $66.07 |
Ambetter Setting Professional Modifier None Typical Low $66.07 Median $77.62 Typical High $77.62 | Professional | None | $66.07 | $77.62 | $77.62 |
BCBS Setting Professional Modifier None Typical Low $83.18 Median $91.20 Typical High $109.65 | Professional | None | $83.18 | $91.20 | $109.65 |
CareSource Setting Facility Modifier None Typical Low $95.50 Median $95.50 Typical High $95.50 | Facility | None | $95.50 | $95.50 | $95.50 |
CareSource Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
Cigna Setting Facility Modifier None Typical Low $60.26 Median $61.66 Typical High $77.62 | Facility | None | $60.26 | $61.66 | $77.62 |
Cigna Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $61.66 | Professional | None | $44.67 | $44.67 | $61.66 |
Qualchoice Setting Professional Modifier None Typical Low $75.86 Median $89.13 Typical High $89.13 | Professional | None | $75.86 | $89.13 | $89.13 |
United Setting Facility Modifier None Typical Low $72.44 Median $109.65 Typical High $131.83 | Facility | None | $72.44 | $109.65 | $131.83 |
United Setting Professional Modifier None Typical Low $37.15 Median $47.86 Typical High $75.86 | Professional | None | $37.15 | $47.86 | $75.86 |
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 $25.70 Median $26.92 Typical High $26.92 | Professional | 52 · Reduced service | $25.70 | $26.92 | $26.92 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.47 Median $10.72 Typical High $10.72 | Professional | 53 · Discontinued | $10.47 | $10.72 | $10.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.76 Median $7.94 Typical High $7.94 | Professional | 55 · Aftercare only | $7.76 | $7.94 | $7.94 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.13 Median $5.37 Typical High $5.37 | Professional | 56 · Pre-op care only | $5.13 | $5.37 | $5.37 |
Where Arkansas sits
The same service costs 2.1 times more in Wisconsin 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· 16th of 51
$83.18
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.