How much rates vary
Facilitymedian $3,020 · 10th to 90th $1,148 to $4,169Professionalmedian $977 · 10th to 90th $832 to $1,230
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 $954.99 Median $1,380.38 Typical High $2,454.71 | Facility | None | $954.99 | $1,380.38 | $2,454.71 |
Aetna Setting Professional Modifier None Typical Low $794.33 Median $977.24 Typical High $1,071.52 | Professional | None | $794.33 | $977.24 | $1,071.52 |
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 $912.01 Median $1,023.29 Typical High $1,230.27 | Professional | None | $912.01 | $1,023.29 | $1,230.27 |
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 $707.95 Median $954.99 Typical High $1,621.81 | Professional | None | $707.95 | $954.99 | $1,621.81 |
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 $398.11 Median $489.78 Typical High $489.78 | Professional | 52 · Reduced service | $398.11 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $194.98 Typical High $194.98 | Professional | 53 · Discontinued | $158.49 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $741.31 Typical High $741.31 | Professional | 54 · Surgery only | $588.84 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $147.91 Typical High $147.91 | Professional | 55 · Aftercare only | $117.49 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $97.72 Typical High $97.72 | Professional | 56 · Pre-op care only | $79.43 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $691.83 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $549.54 | $691.83 | $691.83 |
Where Arkansas sits
The same service costs 3.4 times more in Wisconsin than in Kansas. 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 $8,857KS $2,587
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.