How much rates vary
Facilitymedian $1,445 · 10th to 90th $776 to $3,981Professionalmedian $537 · 10th to 90th $372 to $776
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 $537.03 Median $1,288.25 Typical High $2,454.71 | Facility | None | $537.03 | $1,288.25 | $2,454.71 |
Aetna Setting Professional Modifier None Typical Low $446.68 Median $537.03 Typical High $562.34 | Professional | None | $446.68 | $537.03 | $562.34 |
Ambetter Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $676.08 | Professional | None | $676.08 | $676.08 | $676.08 |
BCBS Arkansas Setting Facility Modifier None Typical Low $1,318.26 Median $2,884.03 Typical High $3,981.07 | Facility | None | $1,318.26 | $2,884.03 | $3,981.07 |
BCBS Arkansas Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $562.34 | Professional | None | $426.58 | $426.58 | $562.34 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $1,288.25 Typical High $1,659.59 | Facility | None | $512.86 | $1,288.25 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $346.74 Median $467.74 Typical High $812.83 | Professional | None | $346.74 | $467.74 | $812.83 |
Qualchoice Setting Professional Modifier None Typical Low $776.25 Median $776.25 Typical High $776.25 | Professional | None | $776.25 | $776.25 | $776.25 |
United Setting Facility Modifier None Typical Low $794.33 Median $1,122.02 Typical High $3,388.44 | Facility | None | $794.33 | $1,122.02 | $3,388.44 |
United Setting Professional Modifier None Typical Low $363.08 Median $436.52 Typical High $870.96 | Professional | None | $363.08 | $436.52 | $870.96 |
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 $218.78 Median $269.15 Typical High $269.15 | Professional | 52 · Reduced service | $218.78 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $107.15 Typical High $107.15 | Professional | 53 · Discontinued | $89.13 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $407.38 Typical High $407.38 | Professional | 54 · Surgery only | $331.13 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $81.28 Typical High $81.28 | Professional | 55 · Aftercare only | $66.07 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $53.70 Typical High $53.70 | Professional | 56 · Pre-op care only | $44.67 | $53.70 | $53.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $380.19 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $309.03 | $380.19 | $380.19 |
Where Arkansas sits
The same service costs 3.6 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 $5,175MT $1,450
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.