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 $190.55 Median $1,000.00 Typical High $2,041.74 | Facility | None | $190.55 | $1,000.00 | $2,041.74 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $239.88 Typical High $309.03 | Professional | None | $190.55 | $239.88 | $309.03 |
Ambetter Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $416.87 | Professional | None | $239.88 | $239.88 | $416.87 |
BCBS Arkansas Setting Facility Modifier None Typical Low $691.83 Median $1,513.56 Typical High $2,089.30 | Facility | None | $691.83 | $1,513.56 | $2,089.30 |
BCBS Arkansas Setting Professional Modifier None Typical Low $165.96 Median $218.78 Typical High $371.54 | Professional | None | $165.96 | $218.78 | $371.54 |
Cigna Setting Facility Modifier None Typical Low $380.19 Median $676.08 Typical High $831.76 | Facility | None | $380.19 | $676.08 | $831.76 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $257.04 Typical High $416.87 | Professional | None | $173.78 | $257.04 | $416.87 |
Qualchoice Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $478.63 | Professional | None | $275.42 | $275.42 | $478.63 |
United Setting Facility Modifier None Typical Low $407.38 Median $588.84 Typical High $2,238.72 | Facility | None | $407.38 | $588.84 | $2,238.72 |
United Setting Professional Modifier None Typical Low $144.54 Median $239.88 Typical High $407.38 | Professional | None | $144.54 | $239.88 | $407.38 |
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 $95.50 Median $112.20 Typical High $154.88 | Professional | 52 · Reduced service | $95.50 | $112.20 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $44.67 Typical High $61.66 | Professional | 53 · Discontinued | $38.02 | $44.67 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $169.82 Typical High $229.09 | Professional | 54 · Surgery only | $141.25 | $169.82 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $33.88 Typical High $45.71 | Professional | 55 · Aftercare only | $28.18 | $33.88 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $22.39 Typical High $30.90 | Professional | 56 · Pre-op care only | $19.05 | $22.39 | $30.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $131.83 Median $158.49 Typical High $213.80 | Professional | 78 · Unplanned return to OR | $131.83 | $158.49 | $213.80 |
Where Arkansas sits
The same service costs 4.5 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· 21st of 51
$282
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.