How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). 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 $107.15 Median $794.33 Typical High $2,041.74 | Facility | None | $107.15 | $794.33 | $2,041.74 |
Aetna Setting Professional Modifier None Typical Low $97.72 Median $125.89 Typical High $158.49 | Professional | None | $97.72 | $125.89 | $158.49 |
Ambetter Setting Professional Modifier None Typical Low $114.82 Median $151.36 Typical High $186.21 | Professional | None | $114.82 | $151.36 | $186.21 |
BCBS Arkansas Setting Facility Modifier None Typical Low $87.10 Median $181.97 Typical High $251.19 | Facility | None | $87.10 | $181.97 | $251.19 |
BCBS Arkansas Setting Professional Modifier None Typical Low $104.71 Median $123.03 Typical High $162.18 | Professional | None | $104.71 | $123.03 | $162.18 |
Cigna Setting Facility Modifier None Typical Low $74.13 Median $79.43 Typical High $109.65 | Facility | None | $74.13 | $79.43 | $109.65 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $151.36 Typical High $194.98 | Professional | None | $85.11 | $151.36 | $194.98 |
Qualchoice Setting Professional Modifier None Typical Low $144.54 Median $177.83 Typical High $213.80 | Professional | None | $144.54 | $177.83 | $213.80 |
United Setting Facility Modifier None Typical Low $79.43 Median $131.83 Typical High $707.95 | Facility | None | $79.43 | $131.83 | $707.95 |
United Setting Professional Modifier None Typical Low $87.10 Median $112.20 Typical High $194.98 | Professional | None | $87.10 | $112.20 | $194.98 |
6 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 $52.48 Median $54.95 Typical High $63.10 | Professional | 52 · Reduced service | $52.48 | $54.95 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $21.88 Typical High $25.70 | Professional | 53 · Discontinued | $21.38 | $21.88 | $25.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $79.43 Median $83.18 Typical High $95.50 | Professional | 54 · Surgery only | $79.43 | $83.18 | $95.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $16.60 Typical High $19.05 | Professional | 55 · Aftercare only | $15.85 | $16.60 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $10.96 Typical High $12.88 | Professional | 56 · Pre-op care only | $10.72 | $10.96 | $12.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $74.13 Median $77.62 Typical High $89.13 | Professional | 78 · Unplanned return to OR | $74.13 | $77.62 | $89.13 |
Where Arkansas sits
The same service costs 4.4 times more in Alaska than in Kentucky. 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· 22nd of 51
$141
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.