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 $194.98 Median $1,000.00 Typical High $2,041.74 | Facility | None | $194.98 | $1,000.00 | $2,041.74 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $213.80 Typical High $281.84 | Professional | None | $186.21 | $213.80 | $281.84 |
Ambetter Setting Professional Modifier None Typical Low $165.96 Median $204.17 Typical High $346.74 | Professional | None | $165.96 | $204.17 | $346.74 |
BCBS Arkansas Setting Facility Modifier None Typical Low $158.49 Median $1,513.56 Typical High $2,089.30 | Facility | None | $158.49 | $1,513.56 | $2,089.30 |
BCBS Arkansas Setting Professional Modifier None Typical Low $181.97 Median $229.09 Typical High $302.00 | Professional | None | $181.97 | $229.09 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $131.83 Median $154.88 Typical High $512.86 | Facility | None | $131.83 | $154.88 | $512.86 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $199.53 Typical High $338.84 | Professional | None | $151.36 | $199.53 | $338.84 |
Qualchoice Setting Professional Modifier None Typical Low $134.90 Median $269.15 Typical High $398.11 | Professional | None | $134.90 | $269.15 | $398.11 |
United Setting Facility Modifier None Typical Low $269.15 Median $363.08 Typical High $1,659.59 | Facility | None | $269.15 | $363.08 | $1,659.59 |
United Setting Professional Modifier None Typical Low $158.49 Median $213.80 Typical High $354.81 | Professional | None | $158.49 | $213.80 | $354.81 |
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 $100.00 Typical High $120.23 | Professional | 52 · Reduced service | $95.50 | $100.00 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $39.81 Typical High $47.86 | Professional | 53 · Discontinued | $38.90 | $39.81 | $47.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $147.91 Typical High $177.83 | Professional | 54 · Surgery only | $144.54 | $147.91 | $177.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $29.51 Typical High $36.31 | Professional | 55 · Aftercare only | $28.84 | $29.51 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $19.95 Typical High $23.99 | Professional | 56 · Pre-op care only | $19.50 | $19.95 | $23.99 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $134.90 Median $138.04 Typical High $165.96 | Professional | 78 · Unplanned return to OR | $134.90 | $138.04 | $165.96 |
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· 26th of 51
$240
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.