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 $204.17 Median $204.17 Typical High $204.17 | Facility | None | $204.17 | $204.17 | $204.17 |
Aetna Setting Professional Modifier None Typical Low $165.96 Median $204.17 Typical High $204.17 | Professional | None | $165.96 | $204.17 | $204.17 |
Ambetter Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $302.00 | Professional | None | $302.00 | $302.00 | $302.00 |
BCBS Arkansas Setting Professional Modifier None Typical Low $323.59 Median $354.81 Typical High $426.58 | Professional | None | $323.59 | $354.81 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $177.83 Median $177.83 Typical High $302.00 | Facility | None | $177.83 | $177.83 | $302.00 |
Cigna Setting Professional Modifier None Typical Low $100.00 Median $128.82 Typical High $177.83 | Professional | None | $100.00 | $128.82 | $177.83 |
United Setting Facility Modifier None Typical Low $186.21 Median $323.59 Typical High $380.19 | Facility | None | $186.21 | $323.59 | $380.19 |
United Setting Professional Modifier None Typical Low $114.82 Median $186.21 Typical High $263.03 | Professional | None | $114.82 | $186.21 | $263.03 |
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 $83.18 Median $102.33 Typical High $102.33 | Professional | 52 · Reduced service | $83.18 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $41.69 Typical High $41.69 | Professional | 53 · Discontinued | $33.11 | $41.69 | $41.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $30.90 Typical High $30.90 | Professional | 55 · Aftercare only | $25.12 | $30.90 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $20.42 Typical High $20.42 | Professional | 56 · Pre-op care only | $16.60 | $20.42 | $20.42 |
Where Arkansas sits
The same service costs 3.5 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· 5th of 51
$324
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.