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 $380.19 Median $380.19 Typical High $380.19 | Facility | None | $380.19 | $380.19 | $380.19 |
Aetna Setting Professional Modifier None Typical Low $302.00 Median $380.19 Typical High $380.19 | Professional | None | $302.00 | $380.19 | $380.19 |
Ambetter Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $562.34 | Professional | None | $562.34 | $562.34 | $562.34 |
BCBS Arkansas Setting Professional Modifier None Typical Low $588.84 Median $660.69 Typical High $794.33 | Professional | None | $588.84 | $660.69 | $794.33 |
Cigna Setting Facility Modifier None Typical Low $380.19 Median $380.19 Typical High $562.34 | Facility | None | $380.19 | $380.19 | $562.34 |
Cigna Setting Professional Modifier None Typical Low $208.93 Median $275.42 Typical High $380.19 | Professional | None | $208.93 | $275.42 | $380.19 |
Qualchoice Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $645.65 | Professional | None | $645.65 | $645.65 | $645.65 |
United Setting Facility Modifier None Typical Low $346.74 Median $676.08 Typical High $794.33 | Facility | None | $346.74 | $676.08 | $794.33 |
United Setting Professional Modifier None Typical Low $245.47 Median $346.74 Typical High $489.78 | Professional | None | $245.47 | $346.74 | $489.78 |
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 $173.78 Median $190.55 Typical High $190.55 | Professional | 52 · Reduced service | $173.78 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $75.86 Typical High $75.86 | Professional | 53 · Discontinued | $70.79 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $57.54 Typical High $57.54 | Professional | 55 · Aftercare only | $52.48 | $57.54 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $38.02 Typical High $38.02 | Professional | 56 · Pre-op care only | $35.48 | $38.02 | $38.02 |
Where Arkansas sits
The same service costs 3.2 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· 8th of 51
$589
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.