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 $50.12 Median $50.12 Typical High $50.12 | Facility | None | $50.12 | $50.12 | $50.12 |
Aetna Setting Professional Modifier None Typical Low $47.86 Median $50.12 Typical High $50.12 | Professional | None | $47.86 | $50.12 | $50.12 |
BCBS Arkansas Setting Professional Modifier None Typical Low $54.95 Median $72.44 Typical High $72.44 | Professional | None | $54.95 | $72.44 | $72.44 |
Cigna Setting Professional Modifier None Typical Low $26.30 Median $26.30 Typical High $26.30 | Professional | None | $26.30 | $26.30 | $26.30 |
United Setting Facility Modifier None Typical Low $61.66 Median $72.44 Typical High $72.44 | Facility | None | $61.66 | $72.44 | $72.44 |
United Setting Professional Modifier None Typical Low $10.00 Median $28.84 Typical High $31.62 | Professional | None | $10.00 | $28.84 | $31.62 |
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 $23.99 Median $25.12 Typical High $25.12 | Professional | 52 · Reduced service | $23.99 | $25.12 | $25.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.55 Median $10.00 Typical High $10.00 | Professional | 53 · Discontinued | $9.55 | $10.00 | $10.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $7.59 Typical High $7.59 | Professional | 55 · Aftercare only | $7.08 | $7.59 | $7.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $5.01 Typical High $5.01 | Professional | 56 · Pre-op care only | $4.79 | $5.01 | $5.01 |
Where Arkansas sits
The same service costs 3.3 times more in Montana than in Indiana. 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· 7th of 51
$54.95
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.