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 $912.01 Median $1,230.27 Typical High $2,041.74 | Facility | None | $912.01 | $1,230.27 | $2,041.74 |
Aetna Setting Professional Modifier None Typical Low $851.14 Median $1,000.00 Typical High $1,258.93 | Professional | None | $851.14 | $1,000.00 | $1,258.93 |
Ambetter Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,122.02 | Professional | None | $1,023.29 | $1,023.29 | $1,122.02 |
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 $812.83 Median $1,000.00 Typical High $1,318.26 | Professional | None | $812.83 | $1,000.00 | $1,318.26 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $1,023.29 Typical High $1,258.93 | Facility | None | $562.34 | $1,023.29 | $1,258.93 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $912.01 Typical High $1,548.82 | Professional | None | $660.69 | $912.01 | $1,548.82 |
Qualchoice Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,288.25 | Professional | None | $1,288.25 | $1,288.25 | $1,288.25 |
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 $776.25 Median $977.24 Typical High $1,621.81 | Professional | None | $776.25 | $977.24 | $1,621.81 |
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 $436.52 Median $457.09 Typical High $549.54 | Professional | 52 · Reduced service | $436.52 | $457.09 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $181.97 Typical High $218.78 | Professional | 53 · Discontinued | $173.78 | $181.97 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $676.08 Typical High $812.83 | Professional | 54 · Surgery only | $660.69 | $676.08 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $134.90 Typical High $162.18 | Professional | 55 · Aftercare only | $131.83 | $134.90 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $91.20 Typical High $109.65 | Professional | 56 · Pre-op care only | $87.10 | $91.20 | $109.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $630.96 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $616.60 | $630.96 | $758.58 |
Where Arkansas sits
The same service costs 4.5 times more in Alaska than in Texas. 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· 33rd of 51
$1,023
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.