How much rates vary
Facilitymedian $4,571 · 10th to 90th $1,072 to $9,120Professionalmedian $851 · 10th to 90th $562 to $1,148
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 $851.14 Median $1,288.25 Typical High $2,454.71 | Facility | None | $851.14 | $1,288.25 | $2,454.71 |
Aetna Setting Professional Modifier None Typical Low $707.95 Median $851.14 Typical High $977.24 | Professional | None | $707.95 | $851.14 | $977.24 |
Ambetter Setting Professional Modifier None Typical Low $131.83 Median $954.99 Typical High $954.99 | Professional | None | $131.83 | $954.99 | $954.99 |
BCBS Arkansas Setting Facility Modifier None Typical Low $4,570.88 Median $6,760.83 Typical High $9,120.11 | Facility | None | $4,570.88 | $6,760.83 | $9,120.11 |
BCBS Arkansas Setting Professional Modifier None Typical Low $758.58 Median $831.76 Typical High $1,000.00 | Professional | None | $758.58 | $831.76 | $1,000.00 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $4,168.69 Typical High $5,248.07 | Facility | None | $562.34 | $4,168.69 | $5,248.07 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $1,148.15 Typical High $1,230.27 | Professional | None | $660.69 | $1,148.15 | $1,230.27 |
Qualchoice Setting Professional Modifier None Typical Low $151.36 Median $1,096.48 Typical High $1,096.48 | Professional | None | $151.36 | $1,096.48 | $1,096.48 |
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 $588.84 Median $794.33 Typical High $1,348.96 | Professional | None | $588.84 | $794.33 | $1,348.96 |
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 $323.59 Median $426.58 Typical High $426.58 | Professional | 52 · Reduced service | $323.59 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $169.82 Typical High $169.82 | Professional | 53 · Discontinued | $128.82 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $630.96 Typical High $630.96 | Professional | 54 · Surgery only | $489.78 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $128.82 Typical High $128.82 | Professional | 55 · Aftercare only | $97.72 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $85.11 Typical High $85.11 | Professional | 56 · Pre-op care only | $64.57 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $588.84 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $457.09 | $588.84 | $588.84 |
Where Arkansas sits
The same service costs 6.1 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 $13,882MT $2,270
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.