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 $5,248.07 Median $5,248.07 Typical High $5,248.07 | Facility | None | $5,248.07 | $5,248.07 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $4,073.80 Median $5,248.07 Typical High $5,248.07 | Professional | None | $4,073.80 | $5,248.07 | $5,248.07 |
BCBS Arkansas Setting Professional Modifier None Typical Low $8,128.31 Median $8,912.51 Typical High $10,715.19 | Professional | None | $8,128.31 | $8,912.51 | $10,715.19 |
Cigna Setting Facility Modifier None Typical Low $4,677.35 Median $4,677.35 Typical High $7,585.78 | Facility | None | $4,677.35 | $4,677.35 | $7,585.78 |
Cigna Setting Professional Modifier None Typical Low $2,511.89 Median $3,467.37 Typical High $4,677.35 | Professional | None | $2,511.89 | $3,467.37 | $4,677.35 |
United Setting Facility Modifier None Typical Low $2,884.03 Median $8,128.31 Typical High $9,549.93 | Facility | None | $2,884.03 | $8,128.31 | $9,549.93 |
United Setting Professional Modifier None Typical Low $2,951.21 Median $4,677.35 Typical High $6,760.83 | Professional | None | $2,951.21 | $4,677.35 | $6,760.83 |
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 $2,041.74 Median $2,630.27 Typical High $2,630.27 | Professional | 52 · Reduced service | $2,041.74 | $2,630.27 | $2,630.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $812.83 Median $1,047.13 Typical High $1,047.13 | Professional | 53 · Discontinued | $812.83 | $1,047.13 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $616.60 Median $776.25 Typical High $776.25 | Professional | 55 · Aftercare only | $616.60 | $776.25 | $776.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $407.38 Median $524.81 Typical High $524.81 | Professional | 56 · Pre-op care only | $407.38 | $524.81 | $524.81 |
Where Arkansas sits
The same service costs 2.3 times more in Arkansas than in Vermont. 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· 1st of 51
$8,128
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.