How much rates vary
Facilitymedian $4,898 · 10th to 90th $1,175 to $9,120Professionalmedian $912 · 10th to 90th $741 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 $912.01 Median $1,380.38 Typical High $2,454.71 | Facility | None | $912.01 | $1,380.38 | $2,454.71 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $912.01 Typical High $912.01 | Professional | None | $660.69 | $912.01 | $912.01 |
BCBS Arkansas Setting Facility Modifier None Typical Low $4,897.79 Median $6,760.83 Typical High $9,120.11 | Facility | None | $4,897.79 | $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 $562.34 Median $4,168.69 Typical High $5,495.41 | Facility | None | $562.34 | $4,168.69 | $5,495.41 |
Cigna Setting Professional Modifier None Typical Low $707.95 Median $1,202.26 Typical High $1,230.27 | Professional | None | $707.95 | $1,202.26 | $1,230.27 |
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 $630.96 Median $831.76 Typical High $1,412.54 | Professional | None | $630.96 | $831.76 | $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 $457.09 Typical High $457.09 | Professional | 52 · Reduced service | $338.84 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $181.97 Typical High $181.97 | Professional | 53 · Discontinued | $134.90 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $676.08 Typical High $676.08 | Professional | 54 · Surgery only | $501.19 | $676.08 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $134.90 Typical High $134.90 | Professional | 55 · Aftercare only | $100.00 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $91.20 Typical High $91.20 | Professional | 56 · Pre-op care only | $67.61 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $630.96 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $467.74 | $630.96 | $630.96 |
Where Arkansas sits
The same service costs 6.0 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 $14,230MT $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.