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 $117.49 Median $117.49 Typical High $117.49 | Facility | None | $117.49 | $117.49 | $117.49 |
Aetna Setting Professional Modifier None Typical Low $95.50 Median $117.49 Typical High $117.49 | Professional | None | $95.50 | $117.49 | $117.49 |
BCBS Arkansas Setting Professional Modifier None Typical Low $181.97 Median $204.17 Typical High $245.47 | Professional | None | $181.97 | $204.17 | $245.47 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $173.78 | Facility | None | $100.00 | $100.00 | $173.78 |
Cigna Setting Professional Modifier None Typical Low $57.54 Median $72.44 Typical High $100.00 | Professional | None | $57.54 | $72.44 | $100.00 |
United Setting Facility Modifier None Typical Low $102.33 Median $186.21 Typical High $218.78 | Facility | None | $102.33 | $186.21 | $218.78 |
United Setting Professional Modifier None Typical Low $66.07 Median $107.15 Typical High $151.36 | Professional | None | $66.07 | $107.15 | $151.36 |
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 $50.12 Median $58.88 Typical High $58.88 | Professional | 52 · Reduced service | $50.12 | $58.88 | $58.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $23.44 Typical High $23.44 | Professional | 53 · Discontinued | $19.95 | $23.44 | $23.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $17.78 Typical High $17.78 | Professional | 55 · Aftercare only | $14.79 | $17.78 | $17.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $11.75 Typical High $11.75 | Professional | 56 · Pre-op care only | $10.00 | $11.75 | $11.75 |
Where Arkansas sits
The same service costs 4.1 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· 4th of 51
$182
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.