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 $363.08 Median $363.08 Typical High $363.08 | Facility | None | $363.08 | $363.08 | $363.08 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $363.08 Typical High $363.08 | Professional | None | $338.84 | $363.08 | $363.08 |
BCBS Arkansas Setting Professional Modifier None Typical Low $562.34 Median $616.60 Typical High $741.31 | Professional | None | $562.34 | $616.60 | $741.31 |
Cigna Setting Facility Modifier None Typical Low $371.54 Median $371.54 Typical High $537.03 | Facility | None | $371.54 | $371.54 | $537.03 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $275.42 Typical High $371.54 | Professional | None | $199.53 | $275.42 | $371.54 |
United Setting Facility Modifier None Typical Low $269.15 Median $645.65 Typical High $758.58 | Facility | None | $269.15 | $645.65 | $758.58 |
United Setting Professional Modifier None Typical Low $213.80 Median $302.00 Typical High $446.68 | Professional | None | $213.80 | $302.00 | $446.68 |
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 $169.82 Median $181.97 Typical High $181.97 | Professional | 52 · Reduced service | $169.82 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $72.44 Typical High $72.44 | Professional | 53 · Discontinued | $67.61 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $53.70 Typical High $53.70 | Professional | 55 · Aftercare only | $51.29 | $53.70 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $36.31 Typical High $36.31 | Professional | 56 · Pre-op care only | $33.88 | $36.31 | $36.31 |
Where Arkansas sits
The same service costs 3.0 times more in Hawaii than in Vermont. 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
$562
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.