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 $147.91 Median $147.91 Typical High $147.91 | Facility | None | $147.91 | $147.91 | $147.91 |
Aetna Setting Professional Modifier None Typical Low $138.04 Median $147.91 Typical High $147.91 | Professional | None | $138.04 | $147.91 | $147.91 |
Ambetter Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | None | $162.18 | $162.18 | $162.18 |
BCBS Arkansas Setting Professional Modifier None Typical Low $229.09 Median $251.19 Typical High $302.00 | Professional | None | $229.09 | $251.19 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $194.98 Median $194.98 Typical High $213.80 | Facility | None | $194.98 | $194.98 | $213.80 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $165.96 Typical High $194.98 | Professional | None | $85.11 | $165.96 | $194.98 |
Qualchoice Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $186.21 | Professional | None | $186.21 | $186.21 | $186.21 |
United Setting Professional Modifier None Typical Low $97.72 Median $131.83 Typical High $186.21 | Professional | None | $97.72 | $131.83 | $186.21 |
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 $20.42 Median $21.88 Typical High $21.88 | Professional | 55 · Aftercare only | $20.42 | $21.88 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $14.79 Typical High $14.79 | Professional | 56 · Pre-op care only | $13.80 | $14.79 | $14.79 |
Where Arkansas sits
The same service costs 2.6 times more in Montana than in New York. 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· 10th of 51
$229
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.