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 $109.65 Median $112.20 Typical High $131.83 | Professional | None | $109.65 | $112.20 | $131.83 |
Ambetter Setting Professional Modifier None Typical Low $141.25 Median $165.96 Typical High $165.96 | Professional | None | $141.25 | $165.96 | $165.96 |
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 |
CareSource Setting Facility Modifier None Typical Low $204.17 Median $204.17 Typical High $204.17 | Facility | None | $204.17 | $204.17 | $204.17 |
CareSource Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $263.03 | Professional | None | $263.03 | $263.03 | $263.03 |
Cigna Setting Facility Modifier None Typical Low $107.15 Median $125.89 Typical High $165.96 | Facility | None | $107.15 | $125.89 | $165.96 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $125.89 | Professional | None | $93.33 | $93.33 | $125.89 |
Qualchoice Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $190.55 | Professional | None | $190.55 | $190.55 | $190.55 |
United Setting Facility Modifier None Typical Low $208.93 Median $245.47 Typical High $245.47 | Facility | None | $208.93 | $245.47 | $245.47 |
United Setting Professional Modifier None Typical Low $70.79 Median $100.00 Typical High $158.49 | Professional | None | $70.79 | $100.00 | $158.49 |
6 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 |
Cigna Setting Professional Modifier RR · Rental Typical Low $10.72 Median $10.72 Typical High $12.59 | Professional | RR · Rental | $10.72 | $10.72 | $12.59 |
Qualchoice Setting Professional Modifier KX · Policy requirements met Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | KX · Policy requirements met | $162.18 | $162.18 | $162.18 |
Where Arkansas sits
The same service costs 2.1 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· 10th 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.