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 $46.77 Median $46.77 Typical High $46.77 | Facility | None | $46.77 | $46.77 | $46.77 |
Aetna Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $50.12 | Professional | None | $46.77 | $46.77 | $50.12 |
BCBS Arkansas Setting Professional Modifier None Typical Low $51.29 Median $67.61 Typical High $67.61 | Professional | None | $51.29 | $67.61 | $67.61 |
Cigna Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $28.84 | Professional | None | $28.84 | $28.84 | $28.84 |
United Setting Facility Modifier None Typical Low $67.61 Median $79.43 Typical High $79.43 | Facility | None | $67.61 | $79.43 | $79.43 |
United Setting Professional Modifier None Typical Low $10.00 Median $26.30 Typical High $29.51 | Professional | None | $10.00 | $26.30 | $29.51 |
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 $23.44 Median $23.44 Typical High $25.12 | Professional | 52 · Reduced service | $23.44 | $23.44 | $25.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $9.33 Typical High $10.00 | Professional | 53 · Discontinued | $9.33 | $9.33 | $10.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.92 Median $6.92 Typical High $7.41 | Professional | 55 · Aftercare only | $6.92 | $6.92 | $7.41 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.68 Median $4.68 Typical High $5.01 | Professional | 56 · Pre-op care only | $4.68 | $4.68 | $5.01 |
Where Arkansas sits
The same service costs 2.6 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· 12th of 51
$51.29
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.