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 $109.65 Median $128.82 Typical High $194.98 | Professional | None | $109.65 | $128.82 | $194.98 |
Ambetter Setting Professional Modifier None Typical Low $147.91 Median $162.18 Typical High $190.55 | Professional | None | $147.91 | $162.18 | $190.55 |
BCBS Arkansas Setting Facility Modifier None Typical Low $123.03 Median $380.19 Typical High $524.81 | Facility | None | $123.03 | $380.19 | $524.81 |
BCBS Arkansas Setting Professional Modifier None Typical Low $107.15 Median $141.25 Typical High $199.53 | Professional | None | $107.15 | $141.25 | $199.53 |
Cigna Setting Facility Modifier None Typical Low $97.72 Median $107.15 Typical High $138.04 | Facility | None | $97.72 | $107.15 | $138.04 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $165.96 Typical High $239.88 | Professional | None | $93.33 | $165.96 | $239.88 |
Qualchoice Setting Professional Modifier None Typical Low $169.82 Median $186.21 Typical High $218.78 | Professional | None | $169.82 | $186.21 | $218.78 |
United Setting Facility Modifier None Typical Low $79.43 Median $131.83 Typical High $741.31 | Facility | None | $79.43 | $131.83 | $741.31 |
United Setting Professional Modifier None Typical Low $89.13 Median $134.90 Typical High $218.78 | Professional | None | $89.13 | $134.90 | $218.78 |
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 $56.23 Median $63.10 Typical High $81.28 | Professional | 52 · Reduced service | $56.23 | $63.10 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $25.12 Typical High $33.11 | Professional | 53 · Discontinued | $22.39 | $25.12 | $33.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $95.50 Typical High $123.03 | Professional | 54 · Surgery only | $85.11 | $95.50 | $123.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $19.05 Typical High $24.55 | Professional | 55 · Aftercare only | $16.98 | $19.05 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $12.59 Typical High $16.22 | Professional | 56 · Pre-op care only | $11.22 | $12.59 | $16.22 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $79.43 Median $89.13 Typical High $114.82 | Professional | 78 · Unplanned return to OR | $79.43 | $89.13 | $114.82 |
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· 26th of 51
$158
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.