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 $512.86 Median $512.86 Typical High $512.86 | Facility | None | $512.86 | $512.86 | $512.86 |
Aetna Setting Professional Modifier None Typical Low $446.68 Median $512.86 Typical High $512.86 | Professional | None | $446.68 | $512.86 | $512.86 |
BCBS Arkansas Setting Professional Modifier None Typical Low $794.33 Median $891.25 Typical High $1,071.52 | Professional | None | $794.33 | $891.25 | $1,071.52 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $691.83 Typical High $758.58 | Facility | None | $691.83 | $691.83 | $758.58 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $512.86 Typical High $691.83 | Professional | None | $295.12 | $512.86 | $691.83 |
United Setting Facility Modifier None Typical Low $398.11 Median $954.99 Typical High $1,122.02 | Facility | None | $398.11 | $954.99 | $1,122.02 |
United Setting Professional Modifier None Typical Low $346.74 Median $467.74 Typical High $660.69 | Professional | None | $346.74 | $467.74 | $660.69 |
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 $229.09 Median $257.04 Typical High $257.04 | Professional | 52 · Reduced service | $229.09 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $102.33 Typical High $102.33 | Professional | 53 · Discontinued | $91.20 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $77.62 Typical High $77.62 | Professional | 55 · Aftercare only | $67.61 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $51.29 Typical High $51.29 | Professional | 56 · Pre-op care only | $45.71 | $51.29 | $51.29 |
Where Arkansas sits
The same service costs 2.4 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· 12th of 51
$794
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.