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 $100.00 Median $1,000.00 Typical High $2,041.74 | Facility | None | $100.00 | $1,000.00 | $2,041.74 |
Aetna Setting Professional Modifier None Typical Low $93.33 Median $117.49 Typical High $177.83 | Professional | None | $93.33 | $117.49 | $177.83 |
Ambetter Setting Professional Modifier None Typical Low $177.83 Median $208.93 Typical High $213.80 | Professional | None | $177.83 | $208.93 | $213.80 |
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 $87.10 Median $117.49 Typical High $194.98 | Professional | None | $87.10 | $117.49 | $194.98 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $107.15 Typical High $512.86 | Facility | None | $50.12 | $107.15 | $512.86 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $125.89 Typical High $199.53 | Professional | None | $83.18 | $125.89 | $199.53 |
Qualchoice Setting Professional Modifier None Typical Low $204.17 Median $239.88 Typical High $239.88 | Professional | None | $204.17 | $239.88 | $239.88 |
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 $81.28 Median $128.82 Typical High $213.80 | Professional | None | $81.28 | $128.82 | $213.80 |
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 $50.12 Median $57.54 Typical High $75.86 | Professional | 52 · Reduced service | $50.12 | $57.54 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $22.91 Typical High $30.90 | Professional | 53 · Discontinued | $19.95 | $22.91 | $30.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $74.13 Median $85.11 Typical High $114.82 | Professional | 54 · Surgery only | $74.13 | $85.11 | $114.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $16.98 Typical High $22.91 | Professional | 55 · Aftercare only | $14.79 | $16.98 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $11.48 Typical High $15.49 | Professional | 56 · Pre-op care only | $10.00 | $11.48 | $15.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $69.18 Median $79.43 Typical High $107.15 | Professional | 78 · Unplanned return to OR | $69.18 | $79.43 | $107.15 |
Where Arkansas sits
The same service costs 3.5 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· 20th of 51
$155
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.