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 $20.89 Median $20.89 Typical High $20.89 | Facility | None | $20.89 | $20.89 | $20.89 |
Aetna Setting Professional Modifier None Typical Low $18.20 Median $20.89 Typical High $20.89 | Professional | None | $18.20 | $20.89 | $20.89 |
BCBS Arkansas Setting Professional Modifier None Typical Low $21.88 Median $28.84 Typical High $28.84 | Professional | None | $21.88 | $28.84 | $28.84 |
Cigna Setting Professional Modifier None Typical Low $9.77 Median $9.77 Typical High $9.77 | Professional | None | $9.77 | $9.77 | $9.77 |
United Setting Facility Modifier None Typical Low $22.91 Median $26.92 Typical High $26.92 | Facility | None | $22.91 | $26.92 | $26.92 |
United Setting Professional Modifier None Typical Low $6.03 Median $11.75 Typical High $13.18 | Professional | None | $6.03 | $11.75 | $13.18 |
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 $9.12 Median $10.47 Typical High $10.47 | Professional | 52 · Reduced service | $9.12 | $10.47 | $10.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.72 Median $4.17 Typical High $4.17 | Professional | 53 · Discontinued | $3.72 | $4.17 | $4.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.75 Median $3.16 Typical High $3.16 | Professional | 55 · Aftercare only | $2.75 | $3.16 | $3.16 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.82 Median $2.09 Typical High $2.09 | Professional | 56 · Pre-op care only | $1.82 | $2.09 | $2.09 |
Where Arkansas sits
The same service costs 3.2 times more in Montana than in New York. 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· 2nd of 51
$21.88
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.