How much rates vary
Facilitymedian $1,349 · 10th to 90th $759 to $3,631Professionalmedian $251 · 10th to 90th $166 to $372
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 $190.55 Median $1,071.52 Typical High $2,041.74 | Facility | None | $190.55 | $1,071.52 | $2,041.74 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $229.09 Typical High $309.03 | Professional | None | $190.55 | $229.09 | $309.03 |
Ambetter Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $467.74 | Professional | None | $288.40 | $288.40 | $467.74 |
BCBS Arkansas Setting Facility Modifier None Typical Low $1,174.90 Median $2,630.27 Typical High $3,630.78 | Facility | None | $1,174.90 | $2,630.27 | $3,630.78 |
BCBS Arkansas Setting Professional Modifier None Typical Low $177.83 Median $234.42 Typical High $346.74 | Professional | None | $177.83 | $234.42 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $1,071.52 Typical High $1,412.54 | Facility | None | $512.86 | $1,071.52 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $275.42 Typical High $407.38 | Professional | None | $181.97 | $275.42 | $407.38 |
Qualchoice Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $316.23 | Professional | None | $316.23 | $316.23 | $316.23 |
United Setting Facility Modifier None Typical Low $794.33 Median $1,122.02 Typical High $3,388.44 | Facility | None | $794.33 | $1,122.02 | $3,388.44 |
United Setting Professional Modifier None Typical Low $158.49 Median $223.87 Typical High $371.54 | Professional | None | $158.49 | $223.87 | $371.54 |
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 $95.50 Median $109.65 Typical High $131.83 | Professional | 52 · Reduced service | $95.50 | $109.65 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $44.67 Typical High $52.48 | Professional | 53 · Discontinued | $38.90 | $44.67 | $52.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $165.96 Typical High $194.98 | Professional | 54 · Surgery only | $144.54 | $165.96 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $33.11 Typical High $38.90 | Professional | 55 · Aftercare only | $28.84 | $33.11 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $22.39 Typical High $26.30 | Professional | 56 · Pre-op care only | $19.05 | $22.39 | $26.30 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $134.90 Median $154.88 Typical High $181.97 | Professional | 78 · Unplanned return to OR | $134.90 | $154.88 | $181.97 |
Where Arkansas sits
The same service costs 9.3 times more in Colorado than in Montana. 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.
Physician feeFacility fee
CO $5,912MT $637
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.