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 $158.49 Median $1,000.00 Typical High $2,041.74 | Facility | None | $158.49 | $1,000.00 | $2,041.74 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $186.21 Typical High $239.88 | Professional | None | $151.36 | $186.21 | $239.88 |
Ambetter Setting Professional Modifier None Typical Low $190.55 Median $281.84 Typical High $295.12 | Professional | None | $190.55 | $281.84 | $295.12 |
BCBS Arkansas Setting Facility Modifier None Typical Low $141.25 Median $660.69 Typical High $912.01 | Facility | None | $141.25 | $660.69 | $912.01 |
BCBS Arkansas Setting Professional Modifier None Typical Low $147.91 Median $194.98 Typical High $257.04 | Professional | None | $147.91 | $194.98 | $257.04 |
Cigna Setting Facility Modifier None Typical Low $117.49 Median $141.25 Typical High $512.86 | Facility | None | $117.49 | $141.25 | $512.86 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $169.82 Typical High $281.84 | Professional | None | $128.82 | $169.82 | $281.84 |
Qualchoice Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $323.59 | Professional | None | $223.87 | $223.87 | $323.59 |
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 $128.82 Median $181.97 Typical High $295.12 | Professional | None | $128.82 | $181.97 | $295.12 |
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 $79.43 Median $83.18 Typical High $100.00 | Professional | 52 · Reduced service | $79.43 | $83.18 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $33.11 Typical High $39.81 | Professional | 53 · Discontinued | $31.62 | $33.11 | $39.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $125.89 Typical High $151.36 | Professional | 54 · Surgery only | $117.49 | $125.89 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $25.12 Typical High $30.20 | Professional | 55 · Aftercare only | $23.44 | $25.12 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $16.60 Typical High $19.95 | Professional | 56 · Pre-op care only | $15.85 | $16.60 | $19.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $109.65 Median $117.49 Typical High $141.25 | Professional | 78 · Unplanned return to OR | $109.65 | $117.49 | $141.25 |
Where Arkansas sits
The same service costs 3.9 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
$219
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.