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 $281.84 Median $281.84 Typical High $281.84 | Facility | None | $281.84 | $281.84 | $281.84 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $281.84 Typical High $281.84 | Professional | None | $229.09 | $281.84 | $281.84 |
BCBS Arkansas Setting Professional Modifier None Typical Low $436.52 Median $489.78 Typical High $588.84 | Professional | None | $436.52 | $489.78 | $588.84 |
Cigna Setting Facility Modifier None Typical Low $302.00 Median $302.00 Typical High $416.87 | Facility | None | $302.00 | $302.00 | $416.87 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $218.78 Typical High $302.00 | Professional | None | $144.54 | $218.78 | $302.00 |
United Setting Facility Modifier None Typical Low $251.19 Median $549.54 Typical High $549.54 | Facility | None | $251.19 | $549.54 | $549.54 |
United Setting Professional Modifier None Typical Low $169.82 Median $257.04 Typical High $363.08 | Professional | None | $169.82 | $257.04 | $363.08 |
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 $134.90 Median $141.25 Typical High $141.25 | Professional | 52 · Reduced service | $134.90 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $56.23 Typical High $56.23 | Professional | 53 · Discontinued | $54.95 | $56.23 | $56.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $42.66 Typical High $42.66 | Professional | 55 · Aftercare only | $40.74 | $42.66 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $28.18 Typical High $28.18 | Professional | 56 · Pre-op care only | $26.92 | $28.18 | $28.18 |
Where Arkansas sits
The same service costs 2.5 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
$437
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.