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 $407.38 Median $1,000.00 Typical High $2,041.74 | Facility | None | $407.38 | $1,000.00 | $2,041.74 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $407.38 Typical High $478.63 | Professional | None | $346.74 | $407.38 | $478.63 |
BCBS Arkansas Setting Facility Modifier None Typical Low $125.89 Median $208.93 Typical High $288.40 | Facility | None | $125.89 | $208.93 | $288.40 |
BCBS Arkansas Setting Professional Modifier None Typical Low $380.19 Median $426.58 Typical High $549.54 | Professional | None | $380.19 | $426.58 | $549.54 |
Cigna Setting Facility Modifier None Typical Low $123.03 Median $151.36 Typical High $524.81 | Facility | None | $123.03 | $151.36 | $524.81 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $549.54 Typical High $602.56 | Professional | None | $288.40 | $549.54 | $602.56 |
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 $295.12 Median $380.19 Typical High $691.83 | Professional | None | $295.12 | $380.19 | $691.83 |
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 $173.78 Median $204.17 Typical High $223.87 | Professional | 52 · Reduced service | $173.78 | $204.17 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $81.28 Typical High $89.13 | Professional | 53 · Discontinued | $70.79 | $81.28 | $89.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $302.00 Typical High $338.84 | Professional | 54 · Surgery only | $263.03 | $302.00 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $61.66 Typical High $67.61 | Professional | 55 · Aftercare only | $52.48 | $61.66 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $40.74 Typical High $44.67 | Professional | 56 · Pre-op care only | $35.48 | $40.74 | $44.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $281.84 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $245.47 | $281.84 | $316.23 |
Where Arkansas sits
The same service costs 5.1 times more in Alaska than in Utah. 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· 34th of 51
$417
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.