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 $52.48 Median $52.48 Typical High $52.48 | Facility | None | $52.48 | $52.48 | $52.48 |
Aetna Setting Professional Modifier None Typical Low $42.66 Median $52.48 Typical High $52.48 | Professional | None | $42.66 | $52.48 | $52.48 |
BCBS Arkansas Setting Professional Modifier None Typical Low $81.28 Median $89.13 Typical High $107.15 | Professional | None | $81.28 | $89.13 | $107.15 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $56.23 Typical High $75.86 | Facility | None | $56.23 | $56.23 | $75.86 |
Cigna Setting Professional Modifier None Typical Low $29.51 Median $41.69 Typical High $56.23 | Professional | None | $29.51 | $41.69 | $56.23 |
United Setting Facility Modifier None Typical Low $44.67 Median $112.20 Typical High $112.20 | Facility | None | $44.67 | $112.20 | $112.20 |
United Setting Professional Modifier None Typical Low $31.62 Median $43.65 Typical High $64.57 | Professional | None | $31.62 | $43.65 | $64.57 |
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 $24.55 Median $26.30 Typical High $26.30 | Professional | 52 · Reduced service | $24.55 | $26.30 | $26.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.77 Median $10.47 Typical High $10.47 | Professional | 53 · Discontinued | $9.77 | $10.47 | $10.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.41 Median $7.76 Typical High $7.76 | Professional | 55 · Aftercare only | $7.41 | $7.76 | $7.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.90 Median $5.25 Typical High $5.25 | Professional | 56 · Pre-op care only | $4.90 | $5.25 | $5.25 |
Where Arkansas sits
The same service costs 2.6 times more in Kansas than in Arizona. 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
$81.28
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.