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 $112.20 Median $630.96 Typical High $1,862.09 | Facility | None | $112.20 | $630.96 | $1,862.09 |
Aetna Setting Professional Modifier None Typical Low $112.20 Median $144.54 Typical High $257.04 | Professional | None | $112.20 | $144.54 | $257.04 |
Ambetter Setting Professional Modifier None Typical Low $91.20 Median $162.18 Typical High $194.98 | Professional | None | $91.20 | $162.18 | $194.98 |
BCBS Arkansas Setting Facility Modifier None Typical Low $199.53 Median $660.69 Typical High $912.01 | Facility | None | $199.53 | $660.69 | $912.01 |
BCBS Arkansas Setting Professional Modifier None Typical Low $104.71 Median $138.04 Typical High $323.59 | Professional | None | $104.71 | $138.04 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $107.15 Median $208.93 Typical High $263.03 | Facility | None | $107.15 | $208.93 | $263.03 |
Cigna Setting Professional Modifier None Typical Low $91.20 Median $181.97 Typical High $309.03 | Professional | None | $91.20 | $181.97 | $309.03 |
Qualchoice Setting Professional Modifier None Typical Low $104.71 Median $186.21 Typical High $190.55 | Professional | None | $104.71 | $186.21 | $190.55 |
United Setting Facility Modifier None Typical Low $269.15 Median $389.05 Typical High $1,548.82 | Facility | None | $269.15 | $389.05 | $1,548.82 |
United Setting Professional Modifier None Typical Low $91.20 Median $162.18 Typical High $275.42 | Professional | None | $91.20 | $162.18 | $275.42 |
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 $54.95 Median $67.61 Typical High $95.50 | Professional | 52 · Reduced service | $54.95 | $67.61 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $26.92 Typical High $38.02 | Professional | 53 · Discontinued | $22.39 | $26.92 | $38.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $102.33 Typical High $141.25 | Professional | 54 · Surgery only | $83.18 | $102.33 | $141.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $20.42 Typical High $28.84 | Professional | 55 · Aftercare only | $16.60 | $20.42 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $13.49 Typical High $19.05 | Professional | 56 · Pre-op care only | $11.22 | $13.49 | $19.05 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $77.62 Median $95.50 Typical High $131.83 | Professional | 78 · Unplanned return to OR | $77.62 | $95.50 | $131.83 |
Where Arkansas sits
The same service costs 4.1 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· 28th of 51
$209
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.