How much rates vary
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 $239.88 Median $1,000.00 Typical High $2,041.74 | Facility | None | $239.88 | $1,000.00 | $2,041.74 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $239.88 Typical High $263.03 | Professional | None | $190.55 | $239.88 | $263.03 |
Ambetter Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $288.40 | Professional | None | $288.40 | $288.40 | $288.40 |
BCBS Arkansas Setting Facility Modifier None Typical Low $125.89 Median $208.93 Typical High $288.40 | Facility | None | $125.89 | $208.93 | $288.40 |
BCBS Arkansas Setting Professional Modifier None Typical Low $223.87 Median $245.47 Typical High $316.23 | Professional | None | $223.87 | $245.47 | $316.23 |
CareSource Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $263.03 | Professional | None | $263.03 | $263.03 | $263.03 |
Cigna Setting Facility Modifier None Typical Low $107.15 Median $128.82 Typical High $165.96 | Facility | None | $107.15 | $128.82 | $165.96 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $331.13 Typical High $354.81 | Professional | None | $165.96 | $331.13 | $354.81 |
Qualchoice Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $331.13 | Professional | None | $331.13 | $331.13 | $331.13 |
United Setting Facility Modifier None Typical Low $79.43 Median $131.83 Typical High $707.95 | Facility | None | $79.43 | $131.83 | $707.95 |
United Setting Professional Modifier None Typical Low $169.82 Median $218.78 Typical High $398.11 | Professional | None | $169.82 | $218.78 | $398.11 |
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 $102.33 Median $120.23 Typical High $128.82 | Professional | 52 · Reduced service | $102.33 | $120.23 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $48.98 Typical High $52.48 | Professional | 53 · Discontinued | $40.74 | $48.98 | $52.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $181.97 Typical High $194.98 | Professional | 54 · Surgery only | $154.88 | $181.97 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $36.31 Typical High $38.90 | Professional | 55 · Aftercare only | $30.90 | $36.31 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $23.99 Typical High $26.30 | Professional | 56 · Pre-op care only | $20.42 | $23.99 | $26.30 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $144.54 Median $169.82 Typical High $181.97 | Professional | 78 · Unplanned return to OR | $144.54 | $169.82 | $181.97 |
Where Arkansas sits
The same service costs 5.1 times more in Alaska than in Utah. 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.
Arkansas· 34th of 51
$245
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.