How much rates vary
Facilitymedian $1,585 · 10th to 90th $692 to $4,169Professionalmedian $339 · 10th to 90th $263 to $468
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 $338.84 Median $1,071.52 Typical High $2,454.71 | Facility | None | $338.84 | $1,071.52 | $2,454.71 |
Aetna Setting Professional Modifier None Typical Low $245.47 Median $338.84 Typical High $338.84 | Professional | None | $245.47 | $338.84 | $338.84 |
Ambetter Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $302.00 | Professional | None | $302.00 | $302.00 | $302.00 |
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 $288.40 Median $316.23 Typical High $380.19 | Professional | None | $288.40 | $316.23 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $380.19 Median $1,412.54 Typical High $1,862.09 | Facility | None | $380.19 | $1,412.54 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $251.19 Median $467.74 Typical High $489.78 | Professional | None | $251.19 | $467.74 | $489.78 |
Qualchoice Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $346.74 | Professional | None | $346.74 | $346.74 | $346.74 |
United Setting Facility Modifier None Typical Low $794.33 Median $1,122.02 Typical High $3,388.44 | Facility | None | $794.33 | $1,122.02 | $3,388.44 |
United Setting Professional Modifier None Typical Low $229.09 Median $331.13 Typical High $562.34 | Professional | None | $229.09 | $331.13 | $562.34 |
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 $125.89 Median $169.82 Typical High $169.82 | Professional | 52 · Reduced service | $125.89 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $67.61 Typical High $67.61 | Professional | 53 · Discontinued | $50.12 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $251.19 Typical High $251.19 | Professional | 54 · Surgery only | $186.21 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $51.29 Typical High $51.29 | Professional | 55 · Aftercare only | $37.15 | $51.29 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $33.88 Typical High $33.88 | Professional | 56 · Pre-op care only | $25.12 | $33.88 | $33.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $173.78 Median $234.42 Typical High $234.42 | Professional | 78 · Unplanned return to OR | $173.78 | $234.42 | $234.42 |
Where Arkansas sits
The same service costs 7.3 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 $6,269MT $863
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.