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 $165.96 Median $165.96 Typical High $165.96 | Facility | None | $165.96 | $165.96 | $165.96 |
Aetna Setting Professional Modifier None Typical Low $134.90 Median $165.96 Typical High $165.96 | Professional | None | $134.90 | $165.96 | $165.96 |
BCBS Arkansas Setting Professional Modifier None Typical Low $257.04 Median $281.84 Typical High $338.84 | Professional | None | $257.04 | $281.84 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $181.97 Median $181.97 Typical High $239.88 | Facility | None | $181.97 | $181.97 | $239.88 |
Cigna Setting Professional Modifier None Typical Low $79.43 Median $131.83 Typical High $181.97 | Professional | None | $79.43 | $131.83 | $181.97 |
United Setting Facility Modifier None Typical Low $147.91 Median $257.04 Typical High $302.00 | Facility | None | $147.91 | $257.04 | $302.00 |
United Setting Professional Modifier None Typical Low $93.33 Median $147.91 Typical High $213.80 | Professional | None | $93.33 | $147.91 | $213.80 |
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 $66.07 Median $83.18 Typical High $83.18 | Professional | 52 · Reduced service | $66.07 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $33.11 Typical High $33.11 | Professional | 53 · Discontinued | $26.92 | $33.11 | $33.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $24.55 Typical High $24.55 | Professional | 55 · Aftercare only | $19.95 | $24.55 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $16.60 Typical High $16.60 | Professional | 56 · Pre-op care only | $13.49 | $16.60 | $16.60 |
Where Arkansas sits
The same service costs 3.5 times more in Hawaii than in Washington, DC. 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· 5th of 51
$257
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.