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 $41.69 Median $41.69 Typical High $41.69 | Facility | None | $41.69 | $41.69 | $41.69 |
Aetna Setting Professional Modifier None Typical Low $40.74 Median $41.69 Typical High $45.71 | Professional | None | $40.74 | $41.69 | $45.71 |
Ambetter Setting Professional Modifier None Typical Low $26.30 Median $30.90 Typical High $112.20 | Professional | None | $26.30 | $30.90 | $112.20 |
BCBS Arkansas Setting Professional Modifier None Typical Low $42.66 Median $46.77 Typical High $56.23 | Professional | None | $42.66 | $46.77 | $56.23 |
CareSource Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $67.61 | Professional | None | $67.61 | $67.61 | $67.61 |
Cigna Setting Professional Modifier None Typical Low $21.38 Median $21.38 Typical High $42.66 | Professional | None | $21.38 | $21.38 | $42.66 |
Qualchoice Setting Professional Modifier None Typical Low $30.20 Median $35.48 Typical High $128.82 | Professional | None | $30.20 | $35.48 | $128.82 |
United Setting Professional Modifier None Typical Low $16.98 Median $23.44 Typical High $35.48 | Professional | None | $16.98 | $23.44 | $35.48 |
5 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 $20.89 Median $20.89 Typical High $20.89 | Professional | 52 · Reduced service | $20.89 | $20.89 | $20.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.32 Median $8.32 Typical High $8.32 | Professional | 53 · Discontinued | $8.32 | $8.32 | $8.32 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $30.90 Median $30.90 Typical High $30.90 | Professional | 54 · Surgery only | $30.90 | $30.90 | $30.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.17 Median $6.17 Typical High $6.17 | Professional | 55 · Aftercare only | $6.17 | $6.17 | $6.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $4.17 Typical High $4.17 | Professional | 56 · Pre-op care only | $4.17 | $4.17 | $4.17 |
Where Arkansas sits
The same service costs 2.6 times more in Hawaii 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· 17th of 51
$41.69
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.