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 $70.79 Median $70.79 Typical High $70.79 | Facility | None | $70.79 | $70.79 | $70.79 |
Aetna Setting Professional Modifier None Typical Low $69.18 Median $70.79 Typical High $70.79 | Professional | None | $69.18 | $70.79 | $70.79 |
BCBS Arkansas Setting Professional Modifier None Typical Low $112.20 Median $123.03 Typical High $147.91 | Professional | None | $112.20 | $123.03 | $147.91 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $66.07 Typical High $104.71 | Facility | None | $66.07 | $66.07 | $104.71 |
Cigna Setting Professional Modifier None Typical Low $36.31 Median $48.98 Typical High $66.07 | Professional | None | $36.31 | $48.98 | $66.07 |
United Setting Facility Modifier None Typical Low $46.77 Median $117.49 Typical High $138.04 | Facility | None | $46.77 | $117.49 | $138.04 |
United Setting Professional Modifier None Typical Low $38.90 Median $60.26 Typical High $85.11 | Professional | None | $38.90 | $60.26 | $85.11 |
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 $34.67 Median $35.48 Typical High $35.48 | Professional | 52 · Reduced service | $34.67 | $35.48 | $35.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $14.45 Typical High $14.45 | Professional | 53 · Discontinued | $13.80 | $14.45 | $14.45 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $10.72 Typical High $10.72 | Professional | 55 · Aftercare only | $10.47 | $10.72 | $10.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $7.08 Typical High $7.08 | Professional | 56 · Pre-op care only | $6.92 | $7.08 | $7.08 |
Where Arkansas sits
The same service costs 2.7 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· 6th of 51
$112
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.