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 $40.74 Median $40.74 Typical High $40.74 | Facility | None | $40.74 | $40.74 | $40.74 |
Aetna Setting Professional Modifier None Typical Low $28.84 Median $40.74 Typical High $40.74 | Professional | None | $28.84 | $40.74 | $40.74 |
BCBS Arkansas Setting Professional Modifier None Typical Low $63.10 Median $70.79 Typical High $85.11 | Professional | None | $63.10 | $70.79 | $85.11 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $34.67 Typical High $60.26 | Facility | None | $34.67 | $34.67 | $60.26 |
Cigna Setting Professional Modifier None Typical Low $19.50 Median $25.12 Typical High $34.67 | Professional | None | $19.50 | $25.12 | $34.67 |
United Setting Facility Modifier None Typical Low $27.54 Median $64.57 Typical High $75.86 | Facility | None | $27.54 | $64.57 | $75.86 |
United Setting Professional Modifier None Typical Low $22.91 Median $37.15 Typical High $52.48 | Professional | None | $22.91 | $37.15 | $52.48 |
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 $16.22 Median $20.42 Typical High $20.42 | Professional | 52 · Reduced service | $16.22 | $20.42 | $20.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.46 Median $8.13 Typical High $8.13 | Professional | 53 · Discontinued | $6.46 | $8.13 | $8.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.79 Median $6.17 Typical High $6.17 | Professional | 55 · Aftercare only | $4.79 | $6.17 | $6.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.24 Median $4.07 Typical High $4.07 | Professional | 56 · Pre-op care only | $3.24 | $4.07 | $4.07 |
Where Arkansas sits
The same service costs 2.5 times more in Hawaii 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· 2nd of 51
$63.10
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.