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 $218.78 Median $218.78 Typical High $218.78 | Facility | None | $218.78 | $218.78 | $218.78 |
Aetna Setting Professional Modifier None Typical Low $173.78 Median $218.78 Typical High $218.78 | Professional | None | $173.78 | $218.78 | $218.78 |
BCBS Arkansas Setting Professional Modifier None Typical Low $338.84 Median $371.54 Typical High $446.68 | Professional | None | $338.84 | $371.54 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $229.09 Median $229.09 Typical High $316.23 | Facility | None | $229.09 | $229.09 | $316.23 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $165.96 Typical High $229.09 | Professional | None | $131.83 | $165.96 | $229.09 |
United Setting Facility Modifier None Typical Low $151.36 Median $426.58 Typical High $501.19 | Facility | None | $151.36 | $426.58 | $501.19 |
United Setting Professional Modifier None Typical Low $151.36 Median $194.98 Typical High $281.84 | Professional | None | $151.36 | $194.98 | $281.84 |
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 $104.71 Median $109.65 Typical High $109.65 | Professional | 52 · Reduced service | $104.71 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $43.65 Typical High $43.65 | Professional | 53 · Discontinued | $41.69 | $43.65 | $43.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $32.36 Typical High $32.36 | Professional | 55 · Aftercare only | $31.62 | $32.36 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $21.88 Typical High $21.88 | Professional | 56 · Pre-op care only | $20.89 | $21.88 | $21.88 |
Where Arkansas sits
The same service costs 2.7 times more in Montana 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· 13th of 51
$339
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.