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 $104.71 Median $1,000.00 Typical High $2,041.74 | Facility | None | $104.71 | $1,000.00 | $2,041.74 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $123.03 Typical High $199.53 | Professional | None | $83.18 | $123.03 | $199.53 |
Ambetter Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $218.78 | Professional | None | $218.78 | $218.78 | $218.78 |
BCBS Arkansas Setting Facility Modifier None Typical Low $380.19 Median $380.19 Typical High $524.81 | Facility | None | $380.19 | $380.19 | $524.81 |
BCBS Arkansas Setting Professional Modifier None Typical Low $93.33 Median $125.89 Typical High $218.78 | Professional | None | $93.33 | $125.89 | $218.78 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $100.00 Typical High $512.86 | Facility | None | $50.12 | $100.00 | $512.86 |
Cigna Setting Professional Modifier None Typical Low $95.50 Median $162.18 Typical High $269.15 | Professional | None | $95.50 | $162.18 | $269.15 |
Qualchoice Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $251.19 | Professional | None | $251.19 | $251.19 | $251.19 |
United Setting Facility Modifier None Typical Low $79.43 Median $131.83 Typical High $741.31 | Facility | None | $79.43 | $131.83 | $741.31 |
United Setting Professional Modifier None Typical Low $74.13 Median $131.83 Typical High $251.19 | Professional | None | $74.13 | $131.83 | $251.19 |
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 $52.48 Median $60.26 Typical High $91.20 | Professional | 52 · Reduced service | $52.48 | $60.26 | $91.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $23.99 Typical High $36.31 | Professional | 53 · Discontinued | $20.89 | $23.99 | $36.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $77.62 Median $89.13 Typical High $134.90 | Professional | 54 · Surgery only | $77.62 | $89.13 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $17.78 Typical High $26.92 | Professional | 55 · Aftercare only | $15.49 | $17.78 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $12.02 Typical High $18.20 | Professional | 56 · Pre-op care only | $10.47 | $12.02 | $18.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $72.44 Median $83.18 Typical High $125.89 | Professional | 78 · Unplanned return to OR | $72.44 | $83.18 | $125.89 |
Where Arkansas sits
The same service costs 4.5 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· 17th of 51
$174
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.