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 $125.89 Median $1,174.90 Typical High $2,041.74 | Facility | None | $125.89 | $1,174.90 | $2,041.74 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $131.83 Typical High $177.83 | Professional | None | $107.15 | $131.83 | $177.83 |
Ambetter Setting Professional Modifier None Typical Low $70.79 Median $204.17 Typical High $208.93 | Professional | None | $70.79 | $204.17 | $208.93 |
BCBS Arkansas Setting Facility Modifier None Typical Low $117.49 Median $660.69 Typical High $912.01 | Facility | None | $117.49 | $660.69 | $912.01 |
BCBS Arkansas Setting Professional Modifier None Typical Low $107.15 Median $141.25 Typical High $190.55 | Professional | None | $107.15 | $141.25 | $190.55 |
Cigna Setting Facility Modifier None Typical Low $95.50 Median $112.20 Typical High $512.86 | Facility | None | $95.50 | $112.20 | $512.86 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $120.23 Typical High $204.17 | Professional | None | $93.33 | $120.23 | $204.17 |
Qualchoice Setting Professional Modifier None Typical Low $81.28 Median $234.42 Typical High $239.88 | Professional | None | $81.28 | $234.42 | $239.88 |
United Setting Facility Modifier None Typical Low $269.15 Median $363.08 Typical High $1,548.82 | Facility | None | $269.15 | $363.08 | $1,548.82 |
United Setting Professional Modifier None Typical Low $91.20 Median $128.82 Typical High $208.93 | Professional | None | $91.20 | $128.82 | $208.93 |
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 $61.66 Typical High $72.44 | Professional | 52 · Reduced service | $56.23 | $61.66 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $24.55 Typical High $28.84 | Professional | 53 · Discontinued | $22.39 | $24.55 | $28.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $91.20 Typical High $107.15 | Professional | 54 · Surgery only | $83.18 | $91.20 | $107.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $18.62 Typical High $21.88 | Professional | 55 · Aftercare only | $16.60 | $18.62 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $12.30 Typical High $14.45 | Professional | 56 · Pre-op care only | $11.22 | $12.30 | $14.45 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $77.62 Median $85.11 Typical High $100.00 | Professional | 78 · Unplanned return to OR | $77.62 | $85.11 | $100.00 |
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· 23rd of 51
$155
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.