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 $48.98 Median $48.98 Typical High $48.98 | Facility | None | $48.98 | $48.98 | $48.98 |
Aetna Setting Professional Modifier None Typical Low $45.71 Median $48.98 Typical High $48.98 | Professional | None | $45.71 | $48.98 | $48.98 |
BCBS Arkansas Setting Professional Modifier None Typical Low $64.57 Median $70.79 Typical High $85.11 | Professional | None | $64.57 | $70.79 | $85.11 |
Cigna Setting Facility Modifier None Typical Low $69.18 Median $69.18 Typical High $72.44 | Facility | None | $69.18 | $69.18 | $72.44 |
Cigna Setting Professional Modifier None Typical Low $28.18 Median $58.88 Typical High $69.18 | Professional | None | $28.18 | $58.88 | $69.18 |
United Setting Facility Modifier None Typical Low $91.20 Median $107.15 Typical High $107.15 | Facility | None | $91.20 | $107.15 | $107.15 |
United Setting Professional Modifier None Typical Low $32.36 Median $43.65 Typical High $63.10 | Professional | None | $32.36 | $43.65 | $63.10 |
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 $22.91 Median $24.55 Typical High $24.55 | Professional | 52 · Reduced service | $22.91 | $24.55 | $24.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.12 Median $9.77 Typical High $9.77 | Professional | 53 · Discontinued | $9.12 | $9.77 | $9.77 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.76 Median $7.41 Typical High $7.41 | Professional | 55 · Aftercare only | $6.76 | $7.41 | $7.41 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.57 Median $4.90 Typical High $4.90 | Professional | 56 · Pre-op care only | $4.57 | $4.90 | $4.90 |
Where Arkansas sits
The same service costs 2.0 times more in Montana than in South Carolina. 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· 20th of 51
$64.57
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.