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 $30.90 Median $30.90 Typical High $30.90 | Facility | None | $30.90 | $30.90 | $30.90 |
Aetna Setting Professional Modifier None Typical Low $28.84 Median $30.90 Typical High $30.90 | Professional | None | $28.84 | $30.90 | $30.90 |
BCBS Arkansas Setting Professional Modifier None Typical Low $28.84 Median $38.02 Typical High $38.02 | Professional | None | $28.84 | $38.02 | $38.02 |
Cigna Setting Professional Modifier None Typical Low $16.60 Median $16.60 Typical High $16.60 | Professional | None | $16.60 | $16.60 | $16.60 |
United Setting Facility Modifier None Typical Low $39.81 Median $46.77 Typical High $46.77 | Facility | None | $39.81 | $46.77 | $46.77 |
United Setting Professional Modifier None Typical Low $14.13 Median $17.78 Typical High $19.50 | Professional | None | $14.13 | $17.78 | $19.50 |
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 $14.13 Median $15.49 Typical High $15.49 | Professional | 52 · Reduced service | $14.13 | $15.49 | $15.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.75 Median $6.17 Typical High $6.17 | Professional | 53 · Discontinued | $5.75 | $6.17 | $6.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.27 Median $4.68 Typical High $4.68 | Professional | 55 · Aftercare only | $4.27 | $4.68 | $4.68 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.88 Median $3.09 Typical High $3.09 | Professional | 56 · Pre-op care only | $2.88 | $3.09 | $3.09 |
Where Arkansas sits
The same service costs 5.9 times more in Hawaii than in Utah. 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· 16th of 51
$28.84
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.