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 $36.31 Median $36.31 Typical High $36.31 | Facility | None | $36.31 | $36.31 | $36.31 |
Aetna Setting Professional Modifier None Typical Low $33.88 Median $36.31 Typical High $36.31 | Professional | None | $33.88 | $36.31 | $36.31 |
BCBS Arkansas Setting Professional Modifier None Typical Low $56.23 Median $61.66 Typical High $74.13 | Professional | None | $56.23 | $61.66 | $74.13 |
Cigna Setting Facility Modifier None Typical Low $44.67 Median $44.67 Typical High $52.48 | Facility | None | $44.67 | $44.67 | $52.48 |
Cigna Setting Professional Modifier None Typical Low $21.88 Median $33.11 Typical High $44.67 | Professional | None | $21.88 | $33.11 | $44.67 |
United Setting Facility Modifier None Typical Low $36.31 Median $70.79 Typical High $83.18 | Facility | None | $36.31 | $70.79 | $83.18 |
United Setting Professional Modifier None Typical Low $25.12 Median $32.36 Typical High $46.77 | Professional | None | $25.12 | $32.36 | $46.77 |
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 $17.38 Median $18.20 Typical High $18.20 | Professional | 52 · Reduced service | $17.38 | $18.20 | $18.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.92 Median $7.24 Typical High $7.24 | Professional | 53 · Discontinued | $6.92 | $7.24 | $7.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.13 Median $5.37 Typical High $5.37 | Professional | 55 · Aftercare only | $5.13 | $5.37 | $5.37 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.47 Median $3.63 Typical High $3.63 | Professional | 56 · Pre-op care only | $3.47 | $3.63 | $3.63 |
Where Arkansas sits
The same service costs 2.5 times more in Hawaii than in Florida. 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
$56.23
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.