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 $199.53 Median $199.53 Typical High $199.53 | Facility | None | $199.53 | $199.53 | $199.53 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $199.53 Typical High $199.53 | Professional | None | $158.49 | $199.53 | $199.53 |
BCBS Arkansas Setting Professional Modifier None Typical Low $316.23 Median $346.74 Typical High $416.87 | Professional | None | $316.23 | $346.74 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $269.15 Median $269.15 Typical High $295.12 | Facility | None | $269.15 | $269.15 | $295.12 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $199.53 Typical High $269.15 | Professional | None | $120.23 | $199.53 | $269.15 |
United Setting Facility Modifier None Typical Low $158.49 Median $389.05 Typical High $457.09 | Facility | None | $158.49 | $389.05 | $457.09 |
United Setting Professional Modifier None Typical Low $141.25 Median $181.97 Typical High $257.04 | Professional | None | $141.25 | $181.97 | $257.04 |
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 $93.33 Median $100.00 Typical High $100.00 | Professional | 52 · Reduced service | $93.33 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $40.74 Typical High $40.74 | Professional | 53 · Discontinued | $37.15 | $40.74 | $40.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $30.20 Typical High $30.20 | Professional | 55 · Aftercare only | $27.54 | $30.20 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $19.95 Typical High $19.95 | Professional | 56 · Pre-op care only | $18.62 | $19.95 | $19.95 |
Where Arkansas sits
The same service costs 2.0 times more in Wisconsin than in Colorado. 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· 14th of 51
$316
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.