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 $151.36 Median $1,000.00 Typical High $2,041.74 | Facility | None | $151.36 | $1,000.00 | $2,041.74 |
Aetna Setting Professional Modifier None Typical Low $141.25 Median $173.78 Typical High $245.47 | Professional | None | $141.25 | $173.78 | $245.47 |
BCBS Arkansas Setting Facility Modifier None Typical Low $151.36 Median $380.19 Typical High $524.81 | Facility | None | $151.36 | $380.19 | $524.81 |
BCBS Arkansas Setting Professional Modifier None Typical Low $131.83 Median $173.78 Typical High $275.42 | Professional | None | $131.83 | $173.78 | $275.42 |
Cigna Setting Facility Modifier None Typical Low $107.15 Median $123.03 Typical High $154.88 | Facility | None | $107.15 | $123.03 | $154.88 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $181.97 Typical High $302.00 | Professional | None | $125.89 | $181.97 | $302.00 |
United Setting Facility Modifier None Typical Low $79.43 Median $131.83 Typical High $741.31 | Facility | None | $79.43 | $131.83 | $741.31 |
United Setting Professional Modifier None Typical Low $123.03 Median $186.21 Typical High $309.03 | Professional | None | $123.03 | $186.21 | $309.03 |
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 $75.86 Median $87.10 Typical High $109.65 | Professional | 52 · Reduced service | $75.86 | $87.10 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $34.67 Typical High $43.65 | Professional | 53 · Discontinued | $30.20 | $34.67 | $43.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $131.83 Typical High $165.96 | Professional | 54 · Surgery only | $112.20 | $131.83 | $165.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $26.30 Typical High $33.11 | Professional | 55 · Aftercare only | $22.91 | $26.30 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $17.38 Typical High $21.88 | Professional | 56 · Pre-op care only | $15.14 | $17.38 | $21.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $104.71 Median $123.03 Typical High $154.88 | Professional | 78 · Unplanned return to OR | $104.71 | $123.03 | $154.88 |
Where Arkansas sits
The same service costs 3.5 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· 33rd of 51
$191
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.