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 $194.98 Median $239.88 Typical High $239.88 | Professional | None | $194.98 | $239.88 | $239.88 |
BCBS Arkansas Setting Professional Modifier None Typical Low $371.54 Median $416.87 Typical High $501.19 | Professional | None | $371.54 | $416.87 | $501.19 |
Cigna Setting Facility Modifier None Typical Low $204.17 Median $204.17 Typical High $354.81 | Facility | None | $204.17 | $204.17 | $354.81 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $147.91 Typical High $204.17 | Professional | None | $117.49 | $147.91 | $204.17 |
United Setting Facility Modifier None Typical Low $181.97 Median $380.19 Typical High $446.68 | Facility | None | $181.97 | $380.19 | $446.68 |
United Setting Professional Modifier None Typical Low $134.90 Median $218.78 Typical High $309.03 | Professional | None | $134.90 | $218.78 | $309.03 |
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 $97.72 Median $120.23 Typical High $120.23 | Professional | 52 · Reduced service | $97.72 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $47.86 Typical High $47.86 | Professional | 53 · Discontinued | $38.90 | $47.86 | $47.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $36.31 Typical High $36.31 | Professional | 55 · Aftercare only | $29.51 | $36.31 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $23.99 Typical High $23.99 | Professional | 56 · Pre-op care only | $19.50 | $23.99 | $23.99 |
Where Arkansas sits
The same service costs 3.3 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· 6th of 51
$372
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.