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 $239.88 Median $239.88 Typical High $239.88 | Facility | None | $239.88 | $239.88 | $239.88 |
Aetna Setting Professional Modifier None Typical Low $204.17 Median $239.88 Typical High $239.88 | Professional | None | $204.17 | $239.88 | $239.88 |
BCBS Arkansas Setting Professional Modifier None Typical Low $380.19 Median $416.87 Typical High $501.19 | Professional | None | $380.19 | $416.87 | $501.19 |
Cigna Setting Facility Modifier None Typical Low $363.08 Median $363.08 Typical High $363.08 | Facility | None | $363.08 | $363.08 | $363.08 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $269.15 Typical High $363.08 | Professional | None | $154.88 | $269.15 | $363.08 |
United Setting Facility Modifier None Typical Low $165.96 Median $501.19 Typical High $588.84 | Facility | None | $165.96 | $501.19 | $588.84 |
United Setting Professional Modifier None Typical Low $169.82 Median $218.78 Typical High $338.84 | Professional | None | $169.82 | $218.78 | $338.84 |
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 $117.49 Median $120.23 Typical High $120.23 | Professional | 52 · Reduced service | $117.49 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $48.98 Typical High $48.98 | Professional | 53 · Discontinued | $46.77 | $48.98 | $48.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $36.31 Typical High $36.31 | Professional | 55 · Aftercare only | $35.48 | $36.31 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $23.99 Typical High $23.99 | Professional | 56 · Pre-op care only | $23.44 | $23.99 | $23.99 |
Where Arkansas sits
The same service costs 2.2 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· 16th of 51
$380
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.