How much rates vary
Facilitymedian $1,778 · 10th to 90th $1,023 to $4,169Professionalmedian $891 · 10th to 90th $741 to $1,175
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 $891.25 Median $1,380.38 Typical High $2,454.71 | Facility | None | $891.25 | $1,380.38 | $2,454.71 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $891.25 Typical High $891.25 | Professional | None | $724.44 | $891.25 | $891.25 |
BCBS Arkansas Setting Facility Modifier None Typical Low $1,513.56 Median $3,019.95 Typical High $4,168.69 | Facility | None | $1,513.56 | $3,019.95 | $4,168.69 |
BCBS Arkansas Setting Professional Modifier None Typical Low $851.14 Median $933.25 Typical High $1,122.02 | Professional | None | $851.14 | $933.25 | $1,122.02 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $1,412.54 Typical High $1,862.09 | Facility | None | $562.34 | $1,412.54 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $1,174.90 Typical High $1,258.93 | Professional | None | $660.69 | $1,174.90 | $1,258.93 |
United Setting Facility Modifier None Typical Low $1,096.48 Median $1,513.56 Typical High $4,466.84 | Facility | None | $1,096.48 | $1,513.56 | $4,466.84 |
United Setting Professional Modifier None Typical Low $645.65 Median $851.14 Typical High $1,479.11 | Professional | None | $645.65 | $851.14 | $1,479.11 |
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 $363.08 Median $436.52 Typical High $436.52 | Professional | 52 · Reduced service | $363.08 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $177.83 Typical High $177.83 | Professional | 53 · Discontinued | $144.54 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $660.69 Typical High $660.69 | Professional | 54 · Surgery only | $537.03 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $131.83 Typical High $131.83 | Professional | 55 · Aftercare only | $107.15 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $89.13 Typical High $89.13 | Professional | 56 · Pre-op care only | $72.44 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $616.60 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $501.19 | $616.60 | $616.60 |
Where Arkansas sits
The same service costs 3.1 times more in Wisconsin than in Hawaii. 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
WI $7,619HI $2,493
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.