How much rates vary
Facilitymedian $3,467 · 10th to 90th $1,288 to $9,120Professionalmedian $1,349 · 10th to 90th $851 to $1,738
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 $1,174.90 Median $1,479.11 Typical High $3,019.95 | Facility | None | $1,174.90 | $1,479.11 | $3,019.95 |
Aetna Setting Professional Modifier None Typical Low $1,071.52 Median $1,258.93 Typical High $1,445.44 | Professional | None | $1,071.52 | $1,258.93 | $1,445.44 |
Ambetter Setting Professional Modifier None Typical Low $194.98 Median $1,412.54 Typical High $1,659.59 | Professional | None | $194.98 | $1,412.54 | $1,659.59 |
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 $1,122.02 Median $1,258.93 Typical High $1,479.11 | Professional | None | $1,122.02 | $1,258.93 | $1,479.11 |
CareSource Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,288.25 | Professional | None | $1,288.25 | $1,288.25 | $1,288.25 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $3,388.44 Typical High $4,168.69 | Facility | None | $831.76 | $3,388.44 | $4,168.69 |
Cigna Setting Professional Modifier None Typical Low $912.01 Median $1,737.80 Typical High $1,819.70 | Professional | None | $912.01 | $1,737.80 | $1,819.70 |
Qualchoice Setting Professional Modifier None Typical Low $223.87 Median $1,621.81 Typical High $1,905.46 | Professional | None | $223.87 | $1,621.81 | $1,905.46 |
United Setting Facility Modifier None Typical Low $1,659.59 Median $2,570.40 Typical High $9,120.11 | Facility | None | $1,659.59 | $2,570.40 | $9,120.11 |
United Setting Professional Modifier None Typical Low $891.25 Median $1,202.26 Typical High $1,995.26 | Professional | None | $891.25 | $1,202.26 | $1,995.26 |
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 $489.78 Median $630.96 Typical High $630.96 | Professional | 52 · Reduced service | $489.78 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $257.04 Typical High $257.04 | Professional | 53 · Discontinued | $194.98 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $954.99 Typical High $954.99 | Professional | 54 · Surgery only | $724.44 | $954.99 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $190.55 Typical High $190.55 | Professional | 55 · Aftercare only | $144.54 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $125.89 Typical High $125.89 | Professional | 56 · Pre-op care only | $97.72 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $891.25 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $676.08 | $891.25 | $891.25 |
Where Arkansas sits
The same service costs 4.2 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 $14,362MT $3,396
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.