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 $79.43 Median $79.43 Typical High $79.43 | Facility | None | $79.43 | $79.43 | $79.43 |
Aetna Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $83.18 | Professional | None | $79.43 | $79.43 | $83.18 |
BCBS Arkansas Setting Professional Modifier None Typical Low $87.10 Median $114.82 Typical High $114.82 | Professional | None | $87.10 | $114.82 | $114.82 |
Cigna Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $48.98 | Professional | None | $48.98 | $48.98 | $48.98 |
United Setting Facility Modifier None Typical Low $117.49 Median $138.04 Typical High $138.04 | Facility | None | $117.49 | $138.04 | $138.04 |
United Setting Professional Modifier None Typical Low $12.02 Median $45.71 Typical High $50.12 | Professional | None | $12.02 | $45.71 | $50.12 |
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 $39.81 Median $39.81 Typical High $41.69 | Professional | 52 · Reduced service | $39.81 | $39.81 | $41.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $15.85 Typical High $16.60 | Professional | 53 · Discontinued | $15.85 | $15.85 | $16.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $12.02 Typical High $12.59 | Professional | 55 · Aftercare only | $12.02 | $12.02 | $12.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $7.94 Typical High $8.32 | Professional | 56 · Pre-op care only | $7.94 | $7.94 | $8.32 |
Where Arkansas sits
The same service costs 2.6 times more in Hawaii 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· 14th of 51
$87.10
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.