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 $141.25 Median $1,000.00 Typical High $2,041.74 | Facility | None | $141.25 | $1,000.00 | $2,041.74 |
Aetna Setting Professional Modifier None Typical Low $120.23 Median $165.96 Typical High $234.42 | Professional | None | $120.23 | $165.96 | $234.42 |
Ambetter Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $295.12 | Professional | None | $275.42 | $275.42 | $295.12 |
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 $123.03 Median $162.18 Typical High $257.04 | Professional | None | $123.03 | $162.18 | $257.04 |
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 $117.49 Median $169.82 Typical High $269.15 | Professional | None | $117.49 | $169.82 | $269.15 |
Qualchoice Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $338.84 | Professional | None | $338.84 | $338.84 | $338.84 |
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 $114.82 Median $173.78 Typical High $288.40 | Professional | None | $114.82 | $173.78 | $288.40 |
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 $70.79 Median $81.28 Typical High $102.33 | Professional | 52 · Reduced service | $70.79 | $81.28 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $32.36 Typical High $40.74 | Professional | 53 · Discontinued | $28.18 | $32.36 | $40.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $123.03 Typical High $154.88 | Professional | 54 · Surgery only | $104.71 | $123.03 | $154.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $24.55 Typical High $30.90 | Professional | 55 · Aftercare only | $20.89 | $24.55 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $16.22 Typical High $20.42 | Professional | 56 · Pre-op care only | $14.13 | $16.22 | $20.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $97.72 Median $114.82 Typical High $144.54 | Professional | 78 · Unplanned return to OR | $97.72 | $114.82 | $144.54 |
Where Arkansas sits
The same service costs 3.3 times more in Alaska than in Maryland. 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· 32nd of 51
$182
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.