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 $147.91 Median $1,000.00 Typical High $2,041.74 | Facility | None | $147.91 | $1,000.00 | $2,041.74 |
Aetna Setting Professional Modifier None Typical Low $147.91 Median $194.98 Typical High $281.84 | Professional | None | $147.91 | $194.98 | $281.84 |
Ambetter Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $239.88 | Professional | None | $239.88 | $239.88 | $239.88 |
BCBS Arkansas Setting Facility Modifier None Typical Low $125.89 Median $213.80 Typical High $288.40 | Facility | None | $125.89 | $213.80 | $288.40 |
BCBS Arkansas Setting Professional Modifier None Typical Low $123.03 Median $162.18 Typical High $346.74 | Professional | None | $123.03 | $162.18 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $107.15 Median $123.03 Typical High $158.49 | Facility | None | $107.15 | $123.03 | $158.49 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $199.53 Typical High $407.38 | Professional | None | $104.71 | $199.53 | $407.38 |
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 $107.15 Median $213.80 Typical High $407.38 | Professional | None | $107.15 | $213.80 | $407.38 |
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 $74.13 Median $79.43 Typical High $141.25 | Professional | 52 · Reduced service | $74.13 | $79.43 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $32.36 Typical High $56.23 | Professional | 53 · Discontinued | $30.20 | $32.36 | $56.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $120.23 Typical High $213.80 | Professional | 54 · Surgery only | $112.20 | $120.23 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $23.99 Typical High $42.66 | Professional | 55 · Aftercare only | $22.39 | $23.99 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $16.22 Typical High $28.18 | Professional | 56 · Pre-op care only | $14.79 | $16.22 | $28.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $104.71 Median $112.20 Typical High $199.53 | Professional | 78 · Unplanned return to OR | $104.71 | $112.20 | $199.53 |
Where Arkansas sits
The same service costs 3.6 times more in Wisconsin than in Kentucky. 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· 38th of 51
$214
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.