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 $57.54 Median $977.24 Typical High $2,041.74 | Facility | None | $57.54 | $977.24 | $2,041.74 |
Aetna Setting Professional Modifier None Typical Low $52.48 Median $67.61 Typical High $87.10 | Professional | None | $52.48 | $67.61 | $87.10 |
Ambetter Setting Professional Modifier None Typical Low $64.57 Median $87.10 Typical High $102.33 | Professional | None | $64.57 | $87.10 | $102.33 |
BCBS Arkansas Setting Facility Modifier None Typical Low $181.97 Median $181.97 Typical High $251.19 | Facility | None | $181.97 | $181.97 | $251.19 |
BCBS Arkansas Setting Professional Modifier None Typical Low $54.95 Median $67.61 Typical High $89.13 | Professional | None | $54.95 | $67.61 | $89.13 |
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 $44.67 Median $67.61 Typical High $104.71 | Professional | None | $44.67 | $67.61 | $104.71 |
Qualchoice Setting Professional Modifier None Typical Low $74.13 Median $102.33 Typical High $117.49 | Professional | None | $74.13 | $102.33 | $117.49 |
United Setting Facility Modifier None Typical Low $79.43 Median $131.83 Typical High $707.95 | Facility | None | $79.43 | $131.83 | $707.95 |
United Setting Professional Modifier None Typical Low $48.98 Median $66.07 Typical High $109.65 | Professional | None | $48.98 | $66.07 | $109.65 |
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 $28.84 Median $29.51 Typical High $35.48 | Professional | 52 · Reduced service | $28.84 | $29.51 | $35.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $11.75 Typical High $14.13 | Professional | 53 · Discontinued | $11.48 | $11.75 | $14.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $42.66 Median $44.67 Typical High $52.48 | Professional | 54 · Surgery only | $42.66 | $44.67 | $52.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $8.91 Typical High $10.47 | Professional | 55 · Aftercare only | $8.51 | $8.91 | $10.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $5.89 Typical High $7.08 | Professional | 56 · Pre-op care only | $5.75 | $5.89 | $7.08 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $39.81 Median $41.69 Typical High $48.98 | Professional | 78 · Unplanned return to OR | $39.81 | $41.69 | $48.98 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $43.65 Median $58.88 Typical High $89.13 | Professional | 59 · Distinct service | $43.65 | $58.88 | $89.13 |
Qualchoice Setting Professional Modifier 59 · Distinct service Typical Low $50.12 Median $93.33 Typical High $109.65 | Professional | 59 · Distinct service | $50.12 | $93.33 | $109.65 |
Where Arkansas sits
The same service costs 4.2 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· 16th of 51
$85.11
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.