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 $457.09 Median $457.09 Typical High $457.09 | Facility | None | $457.09 | $457.09 | $457.09 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $457.09 Typical High $457.09 | Professional | None | $346.74 | $457.09 | $457.09 |
BCBS Arkansas Setting Professional Modifier None Typical Low $707.95 Median $776.25 Typical High $933.25 | Professional | None | $707.95 | $776.25 | $933.25 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $524.81 Typical High $660.69 | Facility | None | $524.81 | $524.81 | $660.69 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $389.05 Typical High $524.81 | Professional | None | $229.09 | $389.05 | $524.81 |
United Setting Facility Modifier None Typical Low $302.00 Median $741.31 Typical High $870.96 | Facility | None | $302.00 | $741.31 | $870.96 |
United Setting Professional Modifier None Typical Low $263.03 Median $407.38 Typical High $588.84 | Professional | None | $263.03 | $407.38 | $588.84 |
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 $177.83 Median $229.09 Typical High $229.09 | Professional | 52 · Reduced service | $177.83 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $91.20 Typical High $91.20 | Professional | 53 · Discontinued | $72.44 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $67.61 Typical High $67.61 | Professional | 55 · Aftercare only | $53.70 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $45.71 Typical High $45.71 | Professional | 56 · Pre-op care only | $35.48 | $45.71 | $45.71 |
Where Arkansas sits
The same service costs 2.3 times more in Hawaii than in Pennsylvania. 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· 7th of 51
$708
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.