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 $223.87 Median $977.24 Typical High $2,041.74 | Facility | None | $223.87 | $977.24 | $2,041.74 |
Aetna Setting Professional Modifier None Typical Low $218.78 Median $263.03 Typical High $389.05 | Professional | None | $218.78 | $263.03 | $389.05 |
Ambetter Setting Professional Modifier None Typical Low $218.78 Median $239.88 Typical High $457.09 | Professional | None | $218.78 | $239.88 | $457.09 |
BCBS Arkansas Setting Facility Modifier None Typical Low $204.17 Median $380.19 Typical High $524.81 | Facility | None | $204.17 | $380.19 | $524.81 |
BCBS Arkansas Setting Professional Modifier None Typical Low $199.53 Median $263.03 Typical High $416.87 | Professional | None | $199.53 | $263.03 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $107.15 Median $194.98 Typical High $245.47 | Facility | None | $107.15 | $194.98 | $245.47 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $323.59 Typical High $489.78 | Professional | None | $177.83 | $323.59 | $489.78 |
Qualchoice Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $524.81 | Professional | None | $251.19 | $251.19 | $524.81 |
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 $186.21 Median $269.15 Typical High $436.52 | Professional | None | $186.21 | $269.15 | $436.52 |
8 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 $112.20 Median $125.89 Typical High $158.49 | Professional | 52 · Reduced service | $112.20 | $125.89 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $50.12 Typical High $63.10 | Professional | 53 · Discontinued | $44.67 | $50.12 | $63.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $190.55 Typical High $234.42 | Professional | 54 · Surgery only | $165.96 | $190.55 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $38.02 Typical High $46.77 | Professional | 55 · Aftercare only | $33.88 | $38.02 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $25.12 Typical High $31.62 | Professional | 56 · Pre-op care only | $22.39 | $25.12 | $31.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $154.88 Median $177.83 Typical High $218.78 | Professional | 78 · Unplanned return to OR | $154.88 | $177.83 | $218.78 |
Ambetter Setting Professional Modifier 79 · Unrelated procedure after surgery Typical Low $223.87 Median $223.87 Typical High $426.58 | Professional | 79 · Unrelated procedure after surgery | $223.87 | $223.87 | $426.58 |
Qualchoice Setting Professional Modifier 79 · Unrelated procedure after surgery Typical Low $257.04 Median $257.04 Typical High $489.78 | Professional | 79 · Unrelated procedure after surgery | $257.04 | $257.04 | $489.78 |
Where Arkansas sits
The same service costs 3.7 times more in Alaska than in Maryland. 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
$302
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.