How much rates vary
Facilitymedian $4,467 · 10th to 90th $1,175 to $9,120Professionalmedian $851 · 10th to 90th $661 to $1,072
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 $794.33 Median $1,380.38 Typical High $2,454.71 | Facility | None | $794.33 | $1,380.38 | $2,454.71 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $794.33 Typical High $794.33 | Professional | None | $616.60 | $794.33 | $794.33 |
Ambetter Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,047.13 | Professional | None | $1,047.13 | $1,047.13 | $1,047.13 |
BCBS Arkansas Setting Facility Modifier None Typical Low $4,466.84 Median $6,760.83 Typical High $9,120.11 | Facility | None | $4,466.84 | $6,760.83 | $9,120.11 |
BCBS Arkansas Setting Professional Modifier None Typical Low $707.95 Median $794.33 Typical High $954.99 | Professional | None | $707.95 | $794.33 | $954.99 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $3,981.07 Typical High $5,011.87 | Facility | None | $562.34 | $3,981.07 | $5,011.87 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $1,071.52 Typical High $1,122.02 | Professional | None | $616.60 | $1,071.52 | $1,122.02 |
Qualchoice Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Professional | None | $1,230.27 | $1,230.27 | $1,230.27 |
United Setting Facility Modifier None Typical Low $1,659.59 Median $2,511.89 Typical High $9,120.11 | Facility | None | $1,659.59 | $2,511.89 | $9,120.11 |
United Setting Professional Modifier None Typical Low $562.34 Median $724.44 Typical High $1,258.93 | Professional | None | $562.34 | $724.44 | $1,258.93 |
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 $309.03 Median $398.11 Typical High $398.11 | Professional | 52 · Reduced service | $309.03 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $158.49 Typical High $158.49 | Professional | 53 · Discontinued | $123.03 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $602.56 Typical High $602.56 | Professional | 54 · Surgery only | $467.74 | $602.56 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $120.23 Typical High $120.23 | Professional | 55 · Aftercare only | $93.33 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $79.43 Typical High $79.43 | Professional | 56 · Pre-op care only | $61.66 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $562.34 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $436.52 | $562.34 | $562.34 |
Where Arkansas sits
The same service costs 6.4 times more in Colorado than in Montana. 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
CO $13,816MT $2,168
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.