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 $316.23 Median $316.23 Typical High $316.23 | Facility | None | $316.23 | $316.23 | $316.23 |
Aetna Setting Professional Modifier None Typical Low $245.47 Median $316.23 Typical High $316.23 | Professional | None | $245.47 | $316.23 | $316.23 |
BCBS Arkansas Setting Professional Modifier None Typical Low $489.78 Median $537.03 Typical High $645.65 | Professional | None | $489.78 | $537.03 | $645.65 |
Cigna Setting Facility Modifier None Typical Low $363.08 Median $363.08 Typical High $457.09 | Facility | None | $363.08 | $363.08 | $457.09 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $263.03 Typical High $363.08 | Professional | None | $177.83 | $263.03 | $363.08 |
United Setting Facility Modifier None Typical Low $575.44 Median $676.08 Typical High $676.08 | Facility | None | $575.44 | $676.08 | $676.08 |
United Setting Professional Modifier None Typical Low $208.93 Median $281.84 Typical High $398.11 | Professional | None | $208.93 | $281.84 | $398.11 |
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 $144.54 Median $154.88 Typical High $154.88 | Professional | 52 · Reduced service | $144.54 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $63.10 Typical High $63.10 | Professional | 53 · Discontinued | $57.54 | $63.10 | $63.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $46.77 Typical High $46.77 | Professional | 55 · Aftercare only | $43.65 | $46.77 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $31.62 Typical High $31.62 | Professional | 56 · Pre-op care only | $28.84 | $31.62 | $31.62 |
Where Arkansas sits
The same service costs 2.2 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· 10th of 51
$490
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.