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 $42.66 Median $42.66 Typical High $42.66 | Facility | None | $42.66 | $42.66 | $42.66 |
Aetna Setting Professional Modifier None Typical Low $39.81 Median $42.66 Typical High $42.66 | Professional | None | $39.81 | $42.66 | $42.66 |
BCBS Arkansas Setting Professional Modifier None Typical Low $56.23 Median $61.66 Typical High $74.13 | Professional | None | $56.23 | $61.66 | $74.13 |
Cigna Setting Facility Modifier None Typical Low $43.65 Median $43.65 Typical High $63.10 | Facility | None | $43.65 | $43.65 | $63.10 |
Cigna Setting Professional Modifier None Typical Low $24.55 Median $37.15 Typical High $43.65 | Professional | None | $24.55 | $37.15 | $43.65 |
United Setting Facility Modifier None Typical Low $79.43 Median $93.33 Typical High $93.33 | Facility | None | $79.43 | $93.33 | $93.33 |
United Setting Professional Modifier None Typical Low $28.18 Median $38.02 Typical High $54.95 | Professional | None | $28.18 | $38.02 | $54.95 |
2 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 55 · Aftercare only Typical Low $5.89 Median $6.46 Typical High $6.46 | Professional | 55 · Aftercare only | $5.89 | $6.46 | $6.46 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.98 Median $4.27 Typical High $4.27 | Professional | 56 · Pre-op care only | $3.98 | $4.27 | $4.27 |
Where Arkansas sits
The same service costs 2.2 times more in Montana than in West 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· 17th of 51
$56.23
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.