How much rates vary
Facilitymedian $1,738 · 10th to 90th $479 to $2,399Professionalmedian $933 · 10th to 90th $661 to $1,318
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 $831.76 Median $1,230.27 Typical High $2,454.71 | Facility | None | $831.76 | $1,230.27 | $2,454.71 |
Aetna Setting Professional Modifier None Typical Low $707.95 Median $870.96 Typical High $1,000.00 | Professional | None | $707.95 | $870.96 | $1,000.00 |
Ambetter Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,288.25 | Professional | None | $1,071.52 | $1,071.52 | $1,288.25 |
BCBS Arkansas Setting Facility Modifier None Typical Low $954.99 Median $1,737.80 Typical High $2,398.83 | Facility | None | $954.99 | $1,737.80 | $2,398.83 |
BCBS Arkansas Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $1,047.13 | Professional | None | $794.33 | $794.33 | $1,047.13 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $1,659.59 Typical High $2,187.76 | Facility | None | $512.86 | $1,659.59 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $588.84 Median $1,202.26 Typical High $1,380.38 | Professional | None | $588.84 | $1,202.26 | $1,380.38 |
Qualchoice Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Professional | None | $1,230.27 | $1,230.27 | $1,230.27 |
United Setting Facility Modifier None Typical Low $407.38 Median $588.84 Typical High $2,511.89 | Facility | None | $407.38 | $588.84 | $2,511.89 |
United Setting Professional Modifier None Typical Low $660.69 Median $831.76 Typical High $1,445.44 | Professional | None | $660.69 | $831.76 | $1,445.44 |
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 $398.11 Median $436.52 Typical High $436.52 | Professional | 52 · Reduced service | $398.11 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $173.78 Typical High $173.78 | Professional | 53 · Discontinued | $158.49 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $660.69 Typical High $660.69 | Professional | 54 · Surgery only | $602.56 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $131.83 Typical High $131.83 | Professional | 55 · Aftercare only | $120.23 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $87.10 Typical High $87.10 | Professional | 56 · Pre-op care only | $79.43 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $616.60 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $562.34 | $616.60 | $616.60 |
Ambetter Setting Professional Modifier 58 · Staged procedure Typical Low $537.03 Median $537.03 Typical High $1,071.52 | Professional | 58 · Staged procedure | $537.03 | $537.03 | $1,071.52 |
Qualchoice Setting Professional Modifier 58 · Staged procedure Typical Low $616.60 Median $1,230.27 Typical High $1,230.27 | Professional | 58 · Staged procedure | $616.60 | $1,230.27 | $1,230.27 |
Where Arkansas sits
The same service costs 3.5 times more in Alaska than in Georgia. 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.
Physician feeFacility fee
AK $7,038GA $2,000
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.