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 $109.65 Median $1,000.00 Typical High $2,041.74 | Facility | None | $109.65 | $1,000.00 | $2,041.74 |
Aetna Setting Professional Modifier None Typical Low $95.50 Median $125.89 Typical High $162.18 | Professional | None | $95.50 | $125.89 | $162.18 |
Ambetter Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $194.98 | Professional | None | $194.98 | $194.98 | $194.98 |
BCBS Arkansas Setting Facility Modifier None Typical Low $102.33 Median $181.97 Typical High $251.19 | Facility | None | $102.33 | $181.97 | $251.19 |
BCBS Arkansas Setting Professional Modifier None Typical Low $95.50 Median $125.89 Typical High $199.53 | Professional | None | $95.50 | $125.89 | $199.53 |
Cigna Setting Facility Modifier None Typical Low $85.11 Median $93.33 Typical High $120.23 | Facility | None | $85.11 | $93.33 | $120.23 |
Cigna Setting Professional Modifier None Typical Low $91.20 Median $134.90 Typical High $204.17 | Professional | None | $91.20 | $134.90 | $204.17 |
Qualchoice Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $223.87 | Professional | None | $223.87 | $223.87 | $223.87 |
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 $87.10 Median $134.90 Typical High $223.87 | Professional | None | $87.10 | $134.90 | $223.87 |
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 $54.95 Median $63.10 Typical High $81.28 | Professional | 52 · Reduced service | $54.95 | $63.10 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $25.12 Typical High $32.36 | Professional | 53 · Discontinued | $21.88 | $25.12 | $32.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $95.50 Typical High $120.23 | Professional | 54 · Surgery only | $81.28 | $95.50 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $19.05 Typical High $23.99 | Professional | 55 · Aftercare only | $16.22 | $19.05 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $12.59 Typical High $16.22 | Professional | 56 · Pre-op care only | $10.96 | $12.59 | $16.22 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $75.86 Median $89.13 Typical High $112.20 | Professional | 78 · Unplanned return to OR | $75.86 | $89.13 | $112.20 |
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· 27th of 51
$145
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.