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 $40.74 Median $40.74 Typical High $40.74 | Facility | None | $40.74 | $40.74 | $40.74 |
Aetna Setting Professional Modifier None Typical Low $38.02 Median $40.74 Typical High $40.74 | Professional | None | $38.02 | $40.74 | $40.74 |
BCBS Arkansas Setting Professional Modifier None Typical Low $44.67 Median $58.88 Typical High $58.88 | Professional | None | $44.67 | $58.88 | $58.88 |
Cigna Setting Professional Modifier None Typical Low $22.39 Median $22.39 Typical High $22.39 | Professional | None | $22.39 | $22.39 | $22.39 |
United Setting Facility Modifier None Typical Low $52.48 Median $61.66 Typical High $61.66 | Facility | None | $52.48 | $61.66 | $61.66 |
United Setting Professional Modifier None Typical Low $10.00 Median $23.44 Typical High $25.70 | Professional | None | $10.00 | $23.44 | $25.70 |
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 $19.05 Median $20.42 Typical High $20.42 | Professional | 52 · Reduced service | $19.05 | $20.42 | $20.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.59 Median $8.13 Typical High $8.13 | Professional | 53 · Discontinued | $7.59 | $8.13 | $8.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.62 Median $6.17 Typical High $6.17 | Professional | 55 · Aftercare only | $5.62 | $6.17 | $6.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.80 Median $4.07 Typical High $4.07 | Professional | 56 · Pre-op care only | $3.80 | $4.07 | $4.07 |
Where Arkansas sits
The same service costs 3.3 times more in Montana than in Missouri. 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· 8th of 51
$44.67
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.