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 $125.89 Median $1,174.90 Typical High $2,454.71 | Facility | None | $125.89 | $1,174.90 | $2,454.71 |
Aetna Setting Professional Modifier None Typical Low $125.89 Median $128.82 Typical High $186.21 | Professional | None | $125.89 | $128.82 | $186.21 |
BCBS Arkansas Setting Facility Modifier None Typical Low $123.03 Median $1,412.54 Typical High $1,949.84 | Facility | None | $123.03 | $1,412.54 | $1,949.84 |
BCBS Arkansas Setting Professional Modifier None Typical Low $104.71 Median $138.04 Typical High $199.53 | Professional | None | $104.71 | $138.04 | $199.53 |
Cigna Setting Facility Modifier None Typical Low $104.71 Median $123.03 Typical High $512.86 | Facility | None | $104.71 | $123.03 | $512.86 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $128.82 Typical High $251.19 | Professional | None | $87.10 | $128.82 | $251.19 |
United Setting Facility Modifier None Typical Low $407.38 Median $588.84 Typical High $2,187.76 | Facility | None | $407.38 | $588.84 | $2,187.76 |
United Setting Professional Modifier None Typical Low $89.13 Median $138.04 Typical High $269.15 | Professional | None | $89.13 | $138.04 | $269.15 |
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 $61.66 Median $64.57 Typical High $93.33 | Professional | 52 · Reduced service | $61.66 | $64.57 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $25.70 Typical High $37.15 | Professional | 53 · Discontinued | $25.12 | $25.70 | $37.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $95.50 Typical High $138.04 | Professional | 54 · Surgery only | $93.33 | $95.50 | $138.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $19.05 Typical High $27.54 | Professional | 55 · Aftercare only | $18.62 | $19.05 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $12.88 Typical High $18.62 | Professional | 56 · Pre-op care only | $12.59 | $12.88 | $18.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $87.10 Median $89.13 Typical High $128.82 | Professional | 78 · Unplanned return to OR | $87.10 | $89.13 | $128.82 |
Where Arkansas sits
The same service costs 4.4 times more in Alaska 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· 25th of 51
$170
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.