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 $223.87 Median $223.87 Typical High $223.87 | Facility | None | $223.87 | $223.87 | $223.87 |
Aetna Setting Professional Modifier None Typical Low $208.93 Median $223.87 Typical High $223.87 | Professional | None | $208.93 | $223.87 | $223.87 |
BCBS Arkansas Setting Professional Modifier None Typical Low $346.74 Median $389.05 Typical High $457.09 | Professional | None | $346.74 | $389.05 | $457.09 |
Cigna Setting Facility Modifier None Typical Low $251.19 Median $251.19 Typical High $331.13 | Facility | None | $251.19 | $251.19 | $331.13 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $199.53 Typical High $251.19 | Professional | None | $144.54 | $199.53 | $251.19 |
United Setting Facility Modifier None Typical Low $204.17 Median $204.17 Typical High $204.17 | Facility | None | $204.17 | $204.17 | $204.17 |
United Setting Professional Modifier None Typical Low $158.49 Median $199.53 Typical High $309.03 | Professional | None | $158.49 | $199.53 | $309.03 |
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 $104.71 Median $112.20 Typical High $112.20 | Professional | 52 · Reduced service | $104.71 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $44.67 Typical High $44.67 | Professional | 53 · Discontinued | $41.69 | $44.67 | $44.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $33.88 Typical High $33.88 | Professional | 55 · Aftercare only | $31.62 | $33.88 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $22.39 Typical High $22.39 | Professional | 56 · Pre-op care only | $20.89 | $22.39 | $22.39 |
Where Arkansas sits
The same service costs 3.4 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· 11th of 51
$347
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.