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 $57.54 Median $57.54 Typical High $57.54 | Facility | None | $57.54 | $57.54 | $57.54 |
Aetna Setting Professional Modifier None Typical Low $53.70 Median $57.54 Typical High $57.54 | Professional | None | $53.70 | $57.54 | $57.54 |
Ambetter Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $85.11 | Professional | None | $85.11 | $85.11 | $85.11 |
BCBS Arkansas Setting Professional Modifier None Typical Low $89.13 Median $97.72 Typical High $117.49 | Professional | None | $89.13 | $97.72 | $117.49 |
CareSource Setting Facility Modifier None Typical Low $117.49 Median $117.49 Typical High $117.49 | Facility | None | $117.49 | $117.49 | $117.49 |
CareSource Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | None | $154.88 | $154.88 | $154.88 |
Cigna Setting Facility Modifier None Typical Low $67.61 Median $67.61 Typical High $85.11 | Facility | None | $67.61 | $67.61 | $85.11 |
Cigna Setting Professional Modifier None Typical Low $36.31 Median $50.12 Typical High $67.61 | Professional | None | $36.31 | $50.12 | $67.61 |
Qualchoice Setting Professional Modifier None Typical Low $45.71 Median $97.72 Typical High $97.72 | Professional | None | $45.71 | $97.72 | $97.72 |
United Setting Facility Modifier None Typical Low $67.61 Median $117.49 Typical High $138.04 | Facility | None | $67.61 | $117.49 | $138.04 |
United Setting Professional Modifier None Typical Low $38.90 Median $50.12 Typical High $75.86 | Professional | None | $38.90 | $50.12 | $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 $27.54 Median $28.84 Typical High $28.84 | Professional | 52 · Reduced service | $27.54 | $28.84 | $28.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $11.48 Typical High $11.48 | Professional | 53 · Discontinued | $10.96 | $11.48 | $11.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $8.71 Typical High $8.71 | Professional | 55 · Aftercare only | $8.32 | $8.71 | $8.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $5.75 Typical High $5.75 | Professional | 56 · Pre-op care only | $5.50 | $5.75 | $5.75 |
Where Arkansas sits
The same service costs 4.1 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· 15th of 51
$89.13
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.