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 $5,623.41 Median $5,623.41 Typical High $5,623.41 | Facility | None | $5,623.41 | $5,623.41 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $5,248.07 Median $5,623.41 Typical High $5,623.41 | Professional | None | $5,248.07 | $5,623.41 | $5,623.41 |
BCBS Arkansas Setting Professional Modifier None Typical Low $8,709.64 Median $9,549.93 Typical High $11,481.54 | Professional | None | $8,709.64 | $9,549.93 | $11,481.54 |
Cigna Setting Facility Modifier None Typical Low $5,623.41 Median $5,623.41 Typical High $8,317.64 | Facility | None | $5,623.41 | $5,623.41 | $8,317.64 |
Cigna Setting Professional Modifier None Typical Low $4,786.30 Median $4,786.30 Typical High $5,623.41 | Professional | None | $4,786.30 | $4,786.30 | $5,623.41 |
United Setting Professional Modifier None Typical Low $3,801.89 Median $5,128.61 Typical High $7,943.28 | Professional | None | $3,801.89 | $5,128.61 | $7,943.28 |
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 $2,630.27 Median $2,818.38 Typical High $2,818.38 | Professional | 52 · Reduced service | $2,630.27 | $2,818.38 | $2,818.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1,047.13 Median $1,122.02 Typical High $1,122.02 | Professional | 53 · Discontinued | $1,047.13 | $1,122.02 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $794.33 Median $851.14 Typical High $851.14 | Professional | 55 · Aftercare only | $794.33 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $524.81 Median $562.34 Typical High $562.34 | Professional | 56 · Pre-op care only | $524.81 | $562.34 | $562.34 |
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· 9th of 51
$8,710
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.