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 $218.78 Median $1,174.90 Typical High $2,041.74 | Facility | None | $218.78 | $1,174.90 | $2,041.74 |
Aetna Setting Professional Modifier None Typical Low $177.83 Median $223.87 Typical High $302.00 | Professional | None | $177.83 | $223.87 | $302.00 |
Ambetter Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $239.88 | Professional | None | $173.78 | $173.78 | $239.88 |
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 $181.97 Median $239.88 Typical High $316.23 | Professional | None | $181.97 | $239.88 | $316.23 |
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 $158.49 Median $208.93 Typical High $346.74 | Professional | None | $158.49 | $208.93 | $346.74 |
Qualchoice Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $275.42 | Professional | None | $199.53 | $199.53 | $275.42 |
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 $162.18 Median $223.87 Typical High $363.08 | Professional | None | $162.18 | $223.87 | $363.08 |
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 $97.72 Median $104.71 Typical High $125.89 | Professional | 52 · Reduced service | $97.72 | $104.71 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $41.69 Typical High $50.12 | Professional | 53 · Discontinued | $38.90 | $41.69 | $50.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $154.88 Typical High $186.21 | Professional | 54 · Surgery only | $147.91 | $154.88 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $30.90 Typical High $37.15 | Professional | 55 · Aftercare only | $29.51 | $30.90 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $20.89 Typical High $25.12 | Professional | 56 · Pre-op care only | $19.50 | $20.89 | $25.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $138.04 Median $144.54 Typical High $173.78 | Professional | 78 · Unplanned return to OR | $138.04 | $144.54 | $173.78 |
Where Arkansas sits
The same service costs 4.7 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· 15th of 51
$316
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.