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 $436.52 Median $436.52 Typical High $436.52 | Facility | None | $436.52 | $436.52 | $436.52 |
Aetna Setting Professional Modifier None Typical Low $354.81 Median $436.52 Typical High $436.52 | Professional | None | $354.81 | $436.52 | $436.52 |
BCBS Arkansas Setting Professional Modifier None Typical Low $676.08 Median $758.58 Typical High $891.25 | Professional | None | $676.08 | $758.58 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $398.11 Typical High $645.65 | Facility | None | $398.11 | $398.11 | $645.65 |
Cigna Setting Professional Modifier None Typical Low $208.93 Median $295.12 Typical High $398.11 | Professional | None | $208.93 | $295.12 | $398.11 |
United Setting Facility Modifier None Typical Low $398.11 Median $691.83 Typical High $812.83 | Facility | None | $398.11 | $691.83 | $812.83 |
United Setting Professional Modifier None Typical Low $245.47 Median $398.11 Typical High $562.34 | Professional | None | $245.47 | $398.11 | $562.34 |
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 $177.83 Median $218.78 Typical High $218.78 | Professional | 52 · Reduced service | $177.83 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $87.10 Typical High $87.10 | Professional | 53 · Discontinued | $70.79 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $66.07 Typical High $66.07 | Professional | 55 · Aftercare only | $53.70 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $43.65 Typical High $43.65 | Professional | 56 · Pre-op care only | $35.48 | $43.65 | $43.65 |
Where Arkansas sits
The same service costs 3.7 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· 3rd of 51
$676
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.