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 $1,621.81 Median $1,621.81 Typical High $1,621.81 | Facility | None | $1,621.81 | $1,621.81 | $1,621.81 |
Aetna Setting Professional Modifier None Typical Low $1,230.27 Median $1,621.81 Typical High $1,621.81 | Professional | None | $1,230.27 | $1,621.81 | $1,621.81 |
Ambetter Setting Professional Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $2,398.83 | Professional | None | $2,398.83 | $2,398.83 | $2,398.83 |
BCBS Arkansas Setting Professional Modifier None Typical Low $2,511.89 Median $2,754.23 Typical High $3,311.31 | Professional | None | $2,511.89 | $2,754.23 | $3,311.31 |
Cigna Setting Facility Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $2,398.83 | Facility | None | $1,819.70 | $1,819.70 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $812.83 Median $1,318.26 Typical High $1,819.70 | Professional | None | $812.83 | $1,318.26 | $1,819.70 |
Qualchoice Setting Professional Modifier None Typical Low $2,754.23 Median $2,754.23 Typical High $2,754.23 | Professional | None | $2,754.23 | $2,754.23 | $2,754.23 |
United Setting Facility Modifier None Typical Low $870.96 Median $2,630.27 Typical High $3,090.30 | Facility | None | $870.96 | $2,630.27 | $3,090.30 |
United Setting Professional Modifier None Typical Low $954.99 Median $1,445.44 Typical High $2,089.30 | Professional | None | $954.99 | $1,445.44 | $2,089.30 |
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 $645.65 Median $812.83 Typical High $812.83 | Professional | 52 · Reduced service | $645.65 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $323.59 Typical High $323.59 | Professional | 53 · Discontinued | $257.04 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $245.47 Typical High $245.47 | Professional | 55 · Aftercare only | $190.55 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $162.18 Typical High $162.18 | Professional | 56 · Pre-op care only | $128.82 | $162.18 | $162.18 |
Where Arkansas sits
The same service costs 2.3 times more in Wisconsin than in Pennsylvania. 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
$2,512
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.