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 $53.70 Median $1,174.90 Typical High $2,454.71 | Facility | None | $53.70 | $1,174.90 | $2,454.71 |
Aetna Setting Professional Modifier None Typical Low $42.66 Median $53.70 Typical High $64.57 | Professional | None | $42.66 | $53.70 | $64.57 |
BCBS Arkansas Setting Facility Modifier None Typical Low $34.67 Median $34.67 Typical High $47.86 | Facility | None | $34.67 | $34.67 | $47.86 |
BCBS Arkansas Setting Professional Modifier None Typical Low $48.98 Median $52.48 Typical High $70.79 | Professional | None | $48.98 | $52.48 | $70.79 |
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 $35.48 Median $47.86 Typical High $87.10 | Professional | None | $35.48 | $47.86 | $87.10 |
United Setting Facility Modifier None Typical Low $77.62 Median $128.82 Typical High $707.95 | Facility | None | $77.62 | $128.82 | $707.95 |
United Setting Professional Modifier None Typical Low $41.69 Median $52.48 Typical High $91.20 | Professional | None | $41.69 | $52.48 | $91.20 |
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 $24.55 Median $26.92 Typical High $28.84 | Professional | 52 · Reduced service | $24.55 | $26.92 | $28.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.77 Median $10.72 Typical High $11.48 | Professional | 53 · Discontinued | $9.77 | $10.72 | $11.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $37.15 Median $40.74 Typical High $42.66 | Professional | 54 · Surgery only | $37.15 | $40.74 | $42.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.41 Median $8.13 Typical High $8.71 | Professional | 55 · Aftercare only | $7.41 | $8.13 | $8.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.90 Median $5.37 Typical High $5.75 | Professional | 56 · Pre-op care only | $4.90 | $5.37 | $5.75 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $34.67 Median $38.02 Typical High $39.81 | Professional | 78 · Unplanned return to OR | $34.67 | $38.02 | $39.81 |
Where Arkansas sits
The same service costs 4.6 times more in Alaska than in New York. 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· 38th of 51
$53.70
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.