How much rates vary
Facilitymedian $3,467 · 10th to 90th $1,413 to $7,413Professionalmedian $1,349 · 10th to 90th $1,096 to $1,820
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 $1,174.90 Median $1,698.24 Typical High $2,818.38 | Facility | None | $1,174.90 | $1,698.24 | $2,818.38 |
Aetna Setting Professional Modifier None Typical Low $977.24 Median $1,348.96 Typical High $1,348.96 | Professional | None | $977.24 | $1,348.96 | $1,348.96 |
BCBS Arkansas Setting Facility Modifier None Typical Low $3,467.37 Median $5,370.32 Typical High $7,413.10 | Facility | None | $3,467.37 | $5,370.32 | $7,413.10 |
BCBS Arkansas Setting Professional Modifier None Typical Low $1,148.15 Median $1,258.93 Typical High $1,513.56 | Professional | None | $1,148.15 | $1,258.93 | $1,513.56 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $2,754.23 Typical High $3,388.44 | Facility | None | $1,000.00 | $2,754.23 | $3,388.44 |
Cigna Setting Professional Modifier None Typical Low $1,047.13 Median $1,778.28 Typical High $1,862.09 | Professional | None | $1,047.13 | $1,778.28 | $1,862.09 |
United Setting Facility Modifier None Typical Low $1,412.54 Median $1,995.26 Typical High $6,918.31 | Facility | None | $1,412.54 | $1,995.26 | $6,918.31 |
United Setting Professional Modifier None Typical Low $912.01 Median $1,174.90 Typical High $2,041.74 | Professional | None | $912.01 | $1,174.90 | $2,041.74 |
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 $489.78 Median $676.08 Typical High $676.08 | Professional | 52 · Reduced service | $489.78 | $676.08 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $269.15 Typical High $269.15 | Professional | 53 · Discontinued | $194.98 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $1,000.00 Typical High $1,000.00 | Professional | 54 · Surgery only | $741.31 | $1,000.00 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $199.53 Typical High $199.53 | Professional | 55 · Aftercare only | $147.91 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $134.90 Typical High $134.90 | Professional | 56 · Pre-op care only | $97.72 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $933.25 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $691.83 | $933.25 | $933.25 |
Where Arkansas sits
The same service costs 6.7 times more in Vermont 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.
Physician feeFacility fee
VT $18,681KY $2,795
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.