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 $15.49 Median $15.49 Typical High $15.49 | Facility | None | $15.49 | $15.49 | $15.49 |
Aetna Setting Professional Modifier None Typical Low $14.45 Median $15.49 Typical High $15.49 | Professional | None | $14.45 | $15.49 | $15.49 |
BCBS Arkansas Setting Professional Modifier None Typical Low $23.99 Median $26.30 Typical High $31.62 | Professional | None | $23.99 | $26.30 | $31.62 |
Cigna Setting Facility Modifier None Typical Low $16.60 Median $16.60 Typical High $22.39 | Facility | None | $16.60 | $16.60 | $22.39 |
Cigna Setting Professional Modifier None Typical Low $8.91 Median $12.02 Typical High $16.60 | Professional | None | $8.91 | $12.02 | $16.60 |
United Setting Facility Modifier None Typical Low $12.88 Median $28.84 Typical High $33.88 | Facility | None | $12.88 | $28.84 | $33.88 |
United Setting Professional Modifier None Typical Low $10.23 Median $13.80 Typical High $19.50 | Professional | None | $10.23 | $13.80 | $19.50 |
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 $7.24 Median $7.76 Typical High $7.76 | Professional | 52 · Reduced service | $7.24 | $7.76 | $7.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.95 Median $3.09 Typical High $3.09 | Professional | 53 · Discontinued | $2.95 | $3.09 | $3.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.19 Median $2.29 Typical High $2.29 | Professional | 55 · Aftercare only | $2.19 | $2.29 | $2.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.45 Median $1.55 Typical High $1.55 | Professional | 56 · Pre-op care only | $1.45 | $1.55 | $1.55 |
Where Arkansas sits
The same service costs 3.0 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· 15th of 51
$23.99
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.