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 $56.23 Median $56.23 Typical High $56.23 | Facility | None | $56.23 | $56.23 | $56.23 |
Aetna Setting Professional Modifier None Typical Low $51.29 Median $56.23 Typical High $56.23 | Professional | None | $51.29 | $56.23 | $56.23 |
BCBS Arkansas Setting Professional Modifier None Typical Low $61.66 Median $81.28 Typical High $81.28 | Professional | None | $61.66 | $81.28 | $81.28 |
Cigna Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
United Setting Facility Modifier None Typical Low $70.79 Median $83.18 Typical High $83.18 | Facility | None | $70.79 | $83.18 | $83.18 |
United Setting Professional Modifier None Typical Low $12.02 Median $32.36 Typical High $35.48 | Professional | None | $12.02 | $32.36 | $35.48 |
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 $25.70 Median $28.18 Typical High $28.18 | Professional | 52 · Reduced service | $25.70 | $28.18 | $28.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.23 Median $11.22 Typical High $11.22 | Professional | 53 · Discontinued | $10.23 | $11.22 | $11.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.76 Median $8.51 Typical High $8.51 | Professional | 55 · Aftercare only | $7.76 | $8.51 | $8.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.13 Median $5.62 Typical High $5.62 | Professional | 56 · Pre-op care only | $5.13 | $5.62 | $5.62 |
Where Arkansas sits
The same service costs 2.8 times more in Montana than in Ohio. 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
$61.66
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.