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 $354.81 Median $1,174.90 Typical High $2,041.74 | Facility | None | $354.81 | $1,174.90 | $2,041.74 |
Aetna Setting Professional Modifier None Typical Low $302.00 Median $354.81 Typical High $489.78 | Professional | None | $302.00 | $354.81 | $489.78 |
Ambetter Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Professional | None | $407.38 | $407.38 | $407.38 |
BCBS 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 Setting Professional Modifier None Typical Low $281.84 Median $371.54 Typical High $512.86 | Professional | None | $281.84 | $371.54 | $512.86 |
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 $257.04 Median $354.81 Typical High $549.54 | Professional | None | $257.04 | $354.81 | $549.54 |
Qualchoice Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $467.74 | Professional | None | $467.74 | $467.74 | $467.74 |
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 $263.03 Median $371.54 Typical High $602.56 | Professional | None | $263.03 | $371.54 | $602.56 |
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 $154.88 Median $169.82 Typical High $213.80 | Professional | 52 · Reduced service | $154.88 | $169.82 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $67.61 Typical High $85.11 | Professional | 53 · Discontinued | $63.10 | $67.61 | $85.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $257.04 Typical High $316.23 | Professional | 54 · Surgery only | $234.42 | $257.04 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $51.29 Typical High $63.10 | Professional | 55 · Aftercare only | $46.77 | $51.29 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $33.88 Typical High $42.66 | Professional | 56 · Pre-op care only | $31.62 | $33.88 | $42.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $218.78 Median $239.88 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $218.78 | $239.88 | $295.12 |
Where Arkansas sits
The same service costs 3.9 times more in Alaska than in Utah. 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· 17th of 51
$501
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.