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 $75.86 Median $977.24 Typical High $2,041.74 | Facility | None | $75.86 | $977.24 | $2,041.74 |
Aetna Setting Professional Modifier None Typical Low $69.18 Median $97.72 Typical High $134.90 | Professional | None | $69.18 | $97.72 | $134.90 |
Ambetter Setting Professional Modifier None Typical Low $107.15 Median $147.91 Typical High $169.82 | Professional | None | $107.15 | $147.91 | $169.82 |
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 $69.18 Median $91.20 Typical High $151.36 | Professional | None | $69.18 | $91.20 | $151.36 |
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 $63.10 Median $97.72 Typical High $165.96 | Professional | None | $63.10 | $97.72 | $165.96 |
Qualchoice Setting Professional Modifier None Typical Low $125.89 Median $169.82 Typical High $199.53 | Professional | None | $125.89 | $169.82 | $199.53 |
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 $60.26 Median $95.50 Typical High $165.96 | Professional | None | $60.26 | $95.50 | $165.96 |
9 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 $38.02 Median $42.66 Typical High $58.88 | Professional | 52 · Reduced service | $38.02 | $42.66 | $58.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $17.38 Typical High $23.44 | Professional | 53 · Discontinued | $15.14 | $17.38 | $23.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $56.23 Median $64.57 Typical High $89.13 | Professional | 54 · Surgery only | $56.23 | $64.57 | $89.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $12.88 Typical High $17.78 | Professional | 55 · Aftercare only | $11.22 | $12.88 | $17.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $8.71 Typical High $11.75 | Professional | 56 · Pre-op care only | $7.59 | $8.71 | $11.75 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $52.48 Median $60.26 Typical High $83.18 | Professional | 78 · Unplanned return to OR | $52.48 | $60.26 | $83.18 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $72.44 Median $158.49 Typical High $169.82 | Professional | 59 · Distinct service | $72.44 | $158.49 | $169.82 |
Qualchoice Setting Professional Modifier 51 · Multiple procedures Typical Low $91.20 Median $91.20 Typical High $154.88 | Professional | 51 · Multiple procedures | $91.20 | $91.20 | $154.88 |
Qualchoice Setting Professional Modifier 59 · Distinct service Typical Low $83.18 Median $154.88 Typical High $199.53 | Professional | 59 · Distinct service | $83.18 | $154.88 | $199.53 |
Where Arkansas sits
The same service costs 3.9 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· 19th of 51
$123
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.