How much rates vary
Facilitymedian $1,072 · 10th to 90th $457 to $1,995Professionalmedian $380 · 10th to 90th $302 to $501
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 $380.19 Median $1,288.25 Typical High $2,454.71 | Facility | None | $380.19 | $1,288.25 | $2,454.71 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $380.19 Typical High $380.19 | Professional | None | $316.23 | $380.19 | $380.19 |
BCBS Arkansas Setting Facility Modifier None Typical Low $812.83 Median $1,445.44 Typical High $1,995.26 | Facility | None | $812.83 | $1,445.44 | $1,995.26 |
BCBS Arkansas Setting Professional Modifier None Typical Low $346.74 Median $389.05 Typical High $467.74 | Professional | None | $346.74 | $389.05 | $467.74 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $812.83 Typical High $977.24 | Facility | None | $512.86 | $812.83 | $977.24 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $501.19 Typical High $537.03 | Professional | None | $288.40 | $501.19 | $537.03 |
United Setting Facility Modifier None Typical Low $407.38 Median $588.84 Typical High $2,187.76 | Facility | None | $407.38 | $588.84 | $2,187.76 |
United Setting Professional Modifier None Typical Low $269.15 Median $331.13 Typical High $616.60 | Professional | None | $269.15 | $331.13 | $616.60 |
8 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 $151.36 Median $190.55 Typical High $190.55 | Professional | 52 · Reduced service | $151.36 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $75.86 Typical High $75.86 | Professional | 53 · Discontinued | $60.26 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $223.87 Median $281.84 Typical High $281.84 | Professional | 54 · Surgery only | $223.87 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $57.54 Typical High $57.54 | Professional | 55 · Aftercare only | $45.71 | $57.54 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $38.02 Typical High $38.02 | Professional | 56 · Pre-op care only | $30.20 | $38.02 | $38.02 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $208.93 Median $269.15 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $208.93 | $269.15 | $269.15 |
Ambetter Setting Professional Modifier 51 · Multiple procedures Typical Low $223.87 Median $223.87 Typical High $223.87 | Professional | 51 · Multiple procedures | $223.87 | $223.87 | $223.87 |
Qualchoice Setting Professional Modifier 51 · Multiple procedures Typical Low $257.04 Median $257.04 Typical High $257.04 | Professional | 51 · Multiple procedures | $257.04 | $257.04 | $257.04 |
Where Arkansas sits
The same service costs 4.6 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 $4,822MT $1,050
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.