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 $112.20 Median $112.20 Typical High $112.20 | Facility | None | $112.20 | $112.20 | $112.20 |
Aetna Setting Professional Modifier None Typical Low $112.20 Median $112.20 Typical High $117.49 | Professional | None | $112.20 | $112.20 | $117.49 |
BCBS Arkansas Setting Professional Modifier None Typical Low $123.03 Median $162.18 Typical High $162.18 | Professional | None | $123.03 | $162.18 | $162.18 |
Cigna Setting Professional Modifier None Typical Low $69.18 Median $69.18 Typical High $69.18 | Professional | None | $69.18 | $69.18 | $69.18 |
United Setting Facility Modifier None Typical Low $162.18 Median $190.55 Typical High $190.55 | Facility | None | $162.18 | $190.55 | $190.55 |
United Setting Professional Modifier None Typical Low $15.14 Median $64.57 Typical High $70.79 | Professional | None | $15.14 | $64.57 | $70.79 |
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 $56.23 Median $56.23 Typical High $58.88 | Professional | 52 · Reduced service | $56.23 | $56.23 | $58.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $22.39 Typical High $23.44 | Professional | 53 · Discontinued | $22.39 | $22.39 | $23.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $16.98 Typical High $17.78 | Professional | 55 · Aftercare only | $16.98 | $16.98 | $17.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $11.22 Typical High $11.75 | Professional | 56 · Pre-op care only | $11.22 | $11.22 | $11.75 |
Where Arkansas sits
The same service costs 3.0 times more in Hawaii 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· 9th of 51
$123
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.