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 $63.10 Median $63.10 Typical High $63.10 | Facility | None | $63.10 | $63.10 | $63.10 |
Aetna Setting Professional Modifier None Typical Low $58.88 Median $63.10 Typical High $63.10 | Professional | None | $58.88 | $63.10 | $63.10 |
BCBS Arkansas Setting Professional Modifier None Typical Low $83.18 Median $91.20 Typical High $109.65 | Professional | None | $83.18 | $91.20 | $109.65 |
Cigna Setting Facility Modifier None Typical Low $91.20 Median $91.20 Typical High $93.33 | Facility | None | $91.20 | $91.20 | $93.33 |
Cigna Setting Professional Modifier None Typical Low $36.31 Median $77.62 Typical High $91.20 | Professional | None | $36.31 | $77.62 | $91.20 |
United Setting Facility Modifier None Typical Low $117.49 Median $138.04 Typical High $138.04 | Facility | None | $117.49 | $138.04 | $138.04 |
United Setting Professional Modifier None Typical Low $42.66 Median $57.54 Typical High $81.28 | Professional | None | $42.66 | $57.54 | $81.28 |
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 $29.51 Median $31.62 Typical High $31.62 | Professional | 52 · Reduced service | $29.51 | $31.62 | $31.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.75 Median $12.59 Typical High $12.59 | Professional | 53 · Discontinued | $11.75 | $12.59 | $12.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $9.55 Typical High $9.55 | Professional | 55 · Aftercare only | $8.91 | $9.55 | $9.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $6.31 Typical High $6.31 | Professional | 56 · Pre-op care only | $5.89 | $6.31 | $6.31 |
Where Arkansas sits
The same service costs 1.9 times more in Montana than in Virginia. 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
$83.18
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.