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 $74.13 Median $74.13 Typical High $74.13 | Facility | None | $74.13 | $74.13 | $74.13 |
Aetna Setting Professional Modifier None Typical Low $63.10 Median $74.13 Typical High $74.13 | Professional | None | $63.10 | $74.13 | $74.13 |
BCBS Arkansas Setting Professional Modifier None Typical Low $114.82 Median $125.89 Typical High $151.36 | Professional | None | $114.82 | $125.89 | $151.36 |
Cigna Setting Facility Modifier None Typical Low $74.13 Median $74.13 Typical High $107.15 | Facility | None | $74.13 | $74.13 | $107.15 |
Cigna Setting Professional Modifier None Typical Low $41.69 Median $53.70 Typical High $74.13 | Professional | None | $41.69 | $53.70 | $74.13 |
United Setting Facility Modifier None Typical Low $77.62 Median $134.90 Typical High $158.49 | Facility | None | $77.62 | $134.90 | $158.49 |
United Setting Professional Modifier None Typical Low $44.67 Median $61.66 Typical High $91.20 | Professional | None | $44.67 | $61.66 | $91.20 |
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 $33.88 Median $36.31 Typical High $36.31 | Professional | 52 · Reduced service | $33.88 | $36.31 | $36.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $14.79 Typical High $14.79 | Professional | 53 · Discontinued | $13.49 | $14.79 | $14.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $10.96 Typical High $10.96 | Professional | 55 · Aftercare only | $10.23 | $10.96 | $10.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $7.41 Typical High $7.41 | Professional | 56 · Pre-op care only | $6.76 | $7.41 | $7.41 |
Where Arkansas sits
The same service costs 3.1 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· 12th of 51
$115
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.