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 $43.65 Median $43.65 Typical High $43.65 | Facility | None | $43.65 | $43.65 | $43.65 |
Aetna Setting Professional Modifier None Typical Low $38.90 Median $43.65 Typical High $43.65 | Professional | None | $38.90 | $43.65 | $43.65 |
BCBS Arkansas Setting Professional Modifier None Typical Low $67.61 Median $74.13 Typical High $89.13 | Professional | None | $67.61 | $74.13 | $89.13 |
Cigna Setting Facility Modifier None Typical Low $48.98 Median $48.98 Typical High $63.10 | Facility | None | $48.98 | $48.98 | $63.10 |
Cigna Setting Professional Modifier None Typical Low $28.18 Median $35.48 Typical High $48.98 | Professional | None | $28.18 | $35.48 | $48.98 |
United Setting Facility Modifier None Typical Low $19.95 Median $89.13 Typical High $107.15 | Facility | None | $19.95 | $89.13 | $107.15 |
United Setting Professional Modifier None Typical Low $30.20 Median $38.90 Typical High $60.26 | Professional | None | $30.20 | $38.90 | $60.26 |
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 $20.89 Median $21.88 Typical High $21.88 | Professional | 52 · Reduced service | $20.89 | $21.88 | $21.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.51 Median $8.71 Typical High $8.71 | Professional | 53 · Discontinued | $8.51 | $8.71 | $8.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $6.46 Typical High $6.46 | Professional | 55 · Aftercare only | $6.31 | $6.46 | $6.46 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.27 Median $4.37 Typical High $4.37 | Professional | 56 · Pre-op care only | $4.27 | $4.37 | $4.37 |
Where Arkansas sits
The same service costs 2.8 times more in Montana than in New Jersey. 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· 14th of 51
$67.61
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.