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 $131.83 Median $1,000.00 Typical High $2,041.74 | Facility | None | $131.83 | $1,000.00 | $2,041.74 |
Aetna Setting Professional Modifier None Typical Low $131.83 Median $162.18 Typical High $208.93 | Professional | None | $131.83 | $162.18 | $208.93 |
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 $123.03 Median $162.18 Typical High $263.03 | Professional | None | $123.03 | $162.18 | $263.03 |
Cigna Setting Facility Modifier None Typical Low $125.89 Median $151.36 Typical High $512.86 | Facility | None | $125.89 | $151.36 | $512.86 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $173.78 Typical High $275.42 | Professional | None | $112.20 | $173.78 | $275.42 |
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 $109.65 Median $173.78 Typical High $288.40 | Professional | None | $109.65 | $173.78 | $288.40 |
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 $66.07 Median $81.28 Typical High $104.71 | Professional | 52 · Reduced service | $66.07 | $81.28 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $32.36 Typical High $41.69 | Professional | 53 · Discontinued | $26.30 | $32.36 | $41.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $100.00 Median $120.23 Typical High $154.88 | Professional | 54 · Surgery only | $100.00 | $120.23 | $154.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $23.99 Typical High $30.90 | Professional | 55 · Aftercare only | $19.95 | $23.99 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $16.22 Typical High $20.89 | Professional | 56 · Pre-op care only | $13.18 | $16.22 | $20.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $93.33 Median $112.20 Typical High $144.54 | Professional | 78 · Unplanned return to OR | $93.33 | $112.20 | $144.54 |
Where Arkansas sits
The same service costs 3.6 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· 20th of 51
$209
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.