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 $100.00 Median $100.00 Typical High $100.00 | Facility | None | $100.00 | $100.00 | $100.00 |
Aetna Setting Professional Modifier None Typical Low $89.13 Median $100.00 Typical High $100.00 | Professional | None | $89.13 | $100.00 | $100.00 |
BCBS Arkansas Setting Professional Modifier None Typical Low $109.65 Median $144.54 Typical High $144.54 | Professional | None | $109.65 | $144.54 | $144.54 |
Cigna Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $52.48 | Professional | None | $52.48 | $52.48 | $52.48 |
United Setting Facility Modifier None Typical Low $123.03 Median $147.91 Typical High $147.91 | Facility | None | $123.03 | $147.91 | $147.91 |
United Setting Professional Modifier None Typical Low $44.67 Median $57.54 Typical High $63.10 | Professional | None | $44.67 | $57.54 | $63.10 |
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 $44.67 Median $50.12 Typical High $50.12 | Professional | 52 · Reduced service | $44.67 | $50.12 | $50.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $19.95 Typical High $19.95 | Professional | 53 · Discontinued | $17.78 | $19.95 | $19.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $15.14 Typical High $15.14 | Professional | 55 · Aftercare only | $13.49 | $15.14 | $15.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $10.00 Typical High $10.00 | Professional | 56 · Pre-op care only | $8.91 | $10.00 | $10.00 |
Where Arkansas sits
The same service costs 3.2 times more in Hawaii than in Arizona. 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
$110
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.