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 $169.82 Median $977.24 Typical High $2,041.74 | Facility | None | $169.82 | $977.24 | $2,041.74 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $194.98 Typical High $257.04 | Professional | None | $158.49 | $194.98 | $257.04 |
Ambetter Setting Professional Modifier None Typical Low $128.82 Median $245.47 Typical High $302.00 | Professional | None | $128.82 | $245.47 | $302.00 |
BCBS Arkansas Setting Facility Modifier None Typical Low $144.54 Median $1,513.56 Typical High $2,089.30 | Facility | None | $144.54 | $1,513.56 | $2,089.30 |
BCBS Arkansas Setting Professional Modifier None Typical Low $158.49 Median $204.17 Typical High $275.42 | Professional | None | $158.49 | $204.17 | $275.42 |
Cigna Setting Facility Modifier None Typical Low $120.23 Median $144.54 Typical High $512.86 | Facility | None | $120.23 | $144.54 | $512.86 |
Cigna Setting Professional Modifier None Typical Low $134.90 Median $181.97 Typical High $302.00 | Professional | None | $134.90 | $181.97 | $302.00 |
Qualchoice Setting Professional Modifier None Typical Low $147.91 Median $288.40 Typical High $346.74 | Professional | None | $147.91 | $288.40 | $346.74 |
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 $141.25 Median $194.98 Typical High $316.23 | Professional | None | $141.25 | $194.98 | $316.23 |
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 $85.11 Median $89.13 Typical High $107.15 | Professional | 52 · Reduced service | $85.11 | $89.13 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $35.48 Typical High $42.66 | Professional | 53 · Discontinued | $33.88 | $35.48 | $42.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $134.90 Typical High $162.18 | Professional | 54 · Surgery only | $128.82 | $134.90 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $26.92 Typical High $32.36 | Professional | 55 · Aftercare only | $25.70 | $26.92 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $17.78 Typical High $21.38 | Professional | 56 · Pre-op care only | $16.98 | $17.78 | $21.38 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $120.23 Median $125.89 Typical High $151.36 | Professional | 78 · Unplanned return to OR | $120.23 | $125.89 | $151.36 |
Where Arkansas sits
The same service costs 4.0 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· 23rd of 51
$229
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.