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 $138.04 Median $138.04 Typical High $138.04 | Facility | None | $138.04 | $138.04 | $138.04 |
Aetna Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $147.91 | Professional | None | $138.04 | $138.04 | $147.91 |
BCBS Arkansas Setting Professional Modifier None Typical Low $151.36 Median $199.53 Typical High $199.53 | Professional | None | $151.36 | $199.53 | $199.53 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $87.10 | Professional | None | $87.10 | $87.10 | $87.10 |
United Setting Facility Modifier None Typical Low $204.17 Median $239.88 Typical High $239.88 | Facility | None | $204.17 | $239.88 | $239.88 |
United Setting Professional Modifier None Typical Low $15.14 Median $79.43 Typical High $87.10 | Professional | None | $15.14 | $79.43 | $87.10 |
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 $69.18 Median $69.18 Typical High $74.13 | Professional | 52 · Reduced service | $69.18 | $69.18 | $74.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $27.54 Typical High $29.51 | Professional | 53 · Discontinued | $27.54 | $27.54 | $29.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $20.89 Typical High $21.88 | Professional | 55 · Aftercare only | $20.89 | $20.89 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $13.80 Typical High $14.79 | Professional | 56 · Pre-op care only | $13.80 | $13.80 | $14.79 |
Where Arkansas sits
The same service costs 5.0 times more in Hawaii than in Florida. 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
$151
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.