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 $602.56 Median $602.56 Typical High $602.56 | Facility | None | $602.56 | $602.56 | $602.56 |
Aetna Setting Professional Modifier None Typical Low $588.84 Median $602.56 Typical High $602.56 | Professional | None | $588.84 | $602.56 | $602.56 |
BCBS Arkansas Setting Professional Modifier None Typical Low $933.25 Median $1,047.13 Typical High $1,258.93 | Professional | None | $933.25 | $1,047.13 | $1,258.93 |
Cigna Setting Facility Modifier None Typical Low $870.96 Median $870.96 Typical High $891.25 | Facility | None | $870.96 | $870.96 | $891.25 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $645.65 Typical High $870.96 | Professional | None | $389.05 | $645.65 | $870.96 |
United Setting Facility Modifier None Typical Low $616.60 Median $1,258.93 Typical High $1,479.11 | Facility | None | $616.60 | $1,258.93 | $1,479.11 |
United Setting Professional Modifier None Typical Low $426.58 Median $549.54 Typical High $831.76 | Professional | None | $426.58 | $549.54 | $831.76 |
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 $295.12 Median $302.00 Typical High $302.00 | Professional | 52 · Reduced service | $295.12 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $120.23 Typical High $120.23 | Professional | 53 · Discontinued | $117.49 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $91.20 Typical High $91.20 | Professional | 55 · Aftercare only | $89.13 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $60.26 Typical High $60.26 | Professional | 56 · Pre-op care only | $58.88 | $60.26 | $60.26 |
Where Arkansas sits
The same service costs 2.3 times more in Hawaii than in Pennsylvania. 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· 17th of 51
$933
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.