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 $229.09 Median $229.09 Typical High $229.09 | Facility | None | $229.09 | $229.09 | $229.09 |
Aetna Setting Professional Modifier None Typical Low $218.78 Median $229.09 Typical High $229.09 | Professional | None | $218.78 | $229.09 | $229.09 |
BCBS Arkansas Setting Professional Modifier None Typical Low $354.81 Median $389.05 Typical High $467.74 | Professional | None | $354.81 | $389.05 | $467.74 |
Cigna Setting Facility Modifier None Typical Low $245.47 Median $245.47 Typical High $331.13 | Facility | None | $245.47 | $245.47 | $331.13 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $177.83 Typical High $245.47 | Professional | None | $125.89 | $177.83 | $245.47 |
United Setting Facility Modifier None Typical Low $234.42 Median $407.38 Typical High $478.63 | Facility | None | $234.42 | $407.38 | $478.63 |
United Setting Professional Modifier None Typical Low $144.54 Median $204.17 Typical High $288.40 | Professional | None | $144.54 | $204.17 | $288.40 |
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 $109.65 Median $114.82 Typical High $114.82 | Professional | 52 · Reduced service | $109.65 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $45.71 Typical High $45.71 | Professional | 53 · Discontinued | $43.65 | $45.71 | $45.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $33.88 Typical High $33.88 | Professional | 55 · Aftercare only | $33.11 | $33.88 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $22.91 Typical High $22.91 | Professional | 56 · Pre-op care only | $21.88 | $22.91 | $22.91 |
Where Arkansas sits
The same service costs 3.6 times more in Hawaii than in Tennessee. 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
$355
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.