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 $204.17 Median $1,071.52 Typical High $2,041.74 | Facility | None | $204.17 | $1,071.52 | $2,041.74 |
Aetna Setting Professional Modifier None Typical Low $194.98 Median $234.42 Typical High $338.84 | Professional | None | $194.98 | $234.42 | $338.84 |
Ambetter Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $251.19 | Professional | None | $251.19 | $251.19 | $251.19 |
BCBS Arkansas Setting Facility Modifier None Typical Low $691.83 Median $1,513.56 Typical High $2,089.30 | Facility | None | $691.83 | $1,513.56 | $2,089.30 |
BCBS Arkansas Setting Professional Modifier None Typical Low $186.21 Median $245.47 Typical High $346.74 | Professional | None | $186.21 | $245.47 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $691.83 Typical High $831.76 | Facility | None | $512.86 | $691.83 | $831.76 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $288.40 Typical High $436.52 | Professional | None | $181.97 | $288.40 | $436.52 |
Qualchoice Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $288.40 | Professional | None | $288.40 | $288.40 | $288.40 |
United Setting Facility Modifier None Typical Low $407.38 Median $588.84 Typical High $2,238.72 | Facility | None | $407.38 | $588.84 | $2,238.72 |
United Setting Professional Modifier None Typical Low $169.82 Median $251.19 Typical High $407.38 | Professional | None | $169.82 | $251.19 | $407.38 |
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 $102.33 Median $114.82 Typical High $147.91 | Professional | 52 · Reduced service | $102.33 | $114.82 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $46.77 Typical High $58.88 | Professional | 53 · Discontinued | $40.74 | $46.77 | $58.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $173.78 Typical High $218.78 | Professional | 54 · Surgery only | $151.36 | $173.78 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $34.67 Typical High $43.65 | Professional | 55 · Aftercare only | $30.20 | $34.67 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $22.91 Typical High $29.51 | Professional | 56 · Pre-op care only | $20.42 | $22.91 | $29.51 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $141.25 Median $162.18 Typical High $204.17 | Professional | 78 · Unplanned return to OR | $141.25 | $162.18 | $204.17 |
Where Arkansas sits
The same service costs 4.2 times more in Alaska 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· 10th of 51
$398
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.