How much rates vary
Facilitymedian $3,467 · 10th to 90th $1,288 to $8,318Professionalmedian $891 · 10th to 90th $589 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 $891.25 Median $1,513.56 Typical High $2,454.71 | Facility | None | $891.25 | $1,513.56 | $2,454.71 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $891.25 Typical High $1,023.29 | Professional | None | $660.69 | $891.25 | $1,023.29 |
Ambetter Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $512.86 | Professional | None | $512.86 | $512.86 | $512.86 |
BCBS Arkansas Setting Facility Modifier None Typical Low $3,388.44 Median $6,760.83 Typical High $9,120.11 | Facility | None | $3,388.44 | $6,760.83 | $9,120.11 |
BCBS Arkansas Setting Professional Modifier None Typical Low $794.33 Median $870.96 Typical High $1,047.13 | Professional | None | $794.33 | $870.96 | $1,047.13 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $3,162.28 Typical High $4,168.69 | Facility | None | $691.83 | $3,162.28 | $4,168.69 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $1,174.90 Typical High $1,230.27 | Professional | None | $691.83 | $1,174.90 | $1,230.27 |
Qualchoice Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $588.84 | Professional | None | $588.84 | $588.84 | $588.84 |
United Setting Facility Modifier None Typical Low $1,412.54 Median $1,995.26 Typical High $6,918.31 | Facility | None | $1,412.54 | $1,995.26 | $6,918.31 |
United Setting Professional Modifier None Typical Low $616.60 Median $812.83 Typical High $1,412.54 | Professional | None | $616.60 | $812.83 | $1,412.54 |
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 $338.84 Median $446.68 Typical High $446.68 | Professional | 52 · Reduced service | $338.84 | $446.68 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $177.83 Typical High $177.83 | Professional | 53 · Discontinued | $138.04 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $676.08 Typical High $676.08 | Professional | 54 · Surgery only | $512.86 | $676.08 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $134.90 Typical High $134.90 | Professional | 55 · Aftercare only | $102.33 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $89.13 Typical High $89.13 | Professional | 56 · Pre-op care only | $67.61 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $630.96 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $478.63 | $630.96 | $630.96 |
Where Arkansas sits
The same service costs 5.7 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 $13,613MT $2,377
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.