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 $218.78 Median $363.08 Typical High $363.08 | Professional | None | $218.78 | $363.08 | $363.08 |
Ambetter Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $537.03 | Professional | None | $537.03 | $537.03 | $537.03 |
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 $309.03 Median $309.03 Typical High $537.03 | Facility | None | $309.03 | $309.03 | $537.03 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $223.87 Typical High $309.03 | Professional | None | $173.78 | $223.87 | $309.03 |
Qualchoice Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $616.60 | Professional | None | $616.60 | $616.60 | $616.60 |
United Setting Facility Modifier None Typical Low $138.04 Median $562.34 Typical High $660.69 | Facility | None | $138.04 | $562.34 | $660.69 |
United Setting Professional Modifier None Typical Low $204.17 Median $323.59 Typical High $457.09 | Professional | None | $204.17 | $323.59 | $457.09 |
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 $154.88 Median $181.97 Typical High $181.97 | Professional | 52 · Reduced service | $154.88 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $72.44 Typical High $72.44 | Professional | 53 · Discontinued | $61.66 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $54.95 Typical High $54.95 | Professional | 55 · Aftercare only | $45.71 | $54.95 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $36.31 Typical High $36.31 | Professional | 56 · Pre-op care only | $30.90 | $36.31 | $36.31 |
Where Arkansas sits
The same service costs 2.7 times more in Montana 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· 6th 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.