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 $70.79 Median $70.79 Typical High $70.79 | Facility | None | $70.79 | $70.79 | $70.79 |
Aetna Setting Professional Modifier None Typical Low $56.23 Median $70.79 Typical High $70.79 | Professional | None | $56.23 | $70.79 | $70.79 |
BCBS Arkansas Setting Professional Modifier None Typical Low $77.62 Median $102.33 Typical High $102.33 | Professional | None | $77.62 | $102.33 | $102.33 |
Cigna Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $32.36 | Professional | None | $32.36 | $32.36 | $32.36 |
United Setting Facility Modifier None Typical Low $77.62 Median $91.20 Typical High $91.20 | Facility | None | $77.62 | $91.20 | $91.20 |
United Setting Professional Modifier None Typical Low $10.00 Median $35.48 Typical High $44.67 | Professional | None | $10.00 | $35.48 | $44.67 |
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 $27.54 Median $35.48 Typical High $35.48 | Professional | 52 · Reduced service | $27.54 | $35.48 | $35.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.22 Median $14.13 Typical High $14.13 | Professional | 53 · Discontinued | $11.22 | $14.13 | $14.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $10.47 Typical High $10.47 | Professional | 55 · Aftercare only | $8.32 | $10.47 | $10.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $7.08 Typical High $7.08 | Professional | 56 · Pre-op care only | $5.62 | $7.08 | $7.08 |
Where Arkansas sits
The same service costs 2.7 times more in Hawaii than in Alabama. 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· 5th of 51
$77.62
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.