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 $131.83 Median $1,000.00 Typical High $2,041.74 | Facility | None | $131.83 | $1,000.00 | $2,041.74 |
Aetna Setting Professional Modifier None Typical Low $131.83 Median $154.88 Typical High $223.87 | Professional | None | $131.83 | $154.88 | $223.87 |
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 $112.20 Median $147.91 Typical High $245.47 | Professional | None | $112.20 | $147.91 | $245.47 |
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 $91.20 Median $158.49 Typical High $309.03 | Professional | None | $91.20 | $158.49 | $309.03 |
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 $95.50 Median $165.96 Typical High $323.59 | Professional | None | $95.50 | $165.96 | $323.59 |
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 $66.07 Median $72.44 Typical High $112.20 | Professional | 52 · Reduced service | $66.07 | $72.44 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $28.84 Typical High $45.71 | Professional | 53 · Discontinued | $26.92 | $28.84 | $45.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $100.00 Median $107.15 Typical High $169.82 | Professional | 54 · Surgery only | $100.00 | $107.15 | $169.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $21.38 Typical High $33.88 | Professional | 55 · Aftercare only | $19.95 | $21.38 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $14.45 Typical High $22.39 | Professional | 56 · Pre-op care only | $13.49 | $14.45 | $22.39 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $93.33 Median $100.00 Typical High $158.49 | Professional | 78 · Unplanned return to OR | $93.33 | $100.00 | $158.49 |
Where Arkansas sits
The same service costs 4.5 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· 40th of 51
$174
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.