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 $112.20 Median $112.20 Typical High $112.20 | Facility | None | $112.20 | $112.20 | $112.20 |
Aetna Setting Professional Modifier None Typical Low $93.33 Median $112.20 Typical High $112.20 | Professional | None | $93.33 | $112.20 | $112.20 |
Ambetter Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Professional | None | $89.13 | $89.13 | $89.13 |
BCBS Arkansas Setting Professional Modifier None Typical Low $173.78 Median $194.98 Typical High $234.42 | Professional | None | $173.78 | $194.98 | $234.42 |
Cigna Setting Facility Modifier None Typical Low $112.20 Median $112.20 Typical High $165.96 | Facility | None | $112.20 | $112.20 | $165.96 |
Cigna Setting Professional Modifier None Typical Low $64.57 Median $83.18 Typical High $112.20 | Professional | None | $64.57 | $83.18 | $112.20 |
Qualchoice Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $102.33 | Professional | None | $102.33 | $102.33 | $102.33 |
United Setting Facility Modifier None Typical Low $97.72 Median $245.47 Typical High $245.47 | Facility | None | $97.72 | $245.47 | $245.47 |
United Setting Professional Modifier None Typical Low $69.18 Median $95.50 Typical High $138.04 | Professional | None | $69.18 | $95.50 | $138.04 |
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 $53.70 Median $56.23 Typical High $56.23 | Professional | 52 · Reduced service | $53.70 | $56.23 | $56.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $22.39 Typical High $22.39 | Professional | 53 · Discontinued | $21.38 | $22.39 | $22.39 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $16.98 Typical High $16.98 | Professional | 55 · Aftercare only | $15.85 | $16.98 | $16.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $11.22 Typical High $11.22 | Professional | 56 · Pre-op care only | $10.72 | $11.22 | $11.22 |
Where Arkansas sits
The same service costs 2.3 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· 11th of 51
$174
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.