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 $478.63 Median $1,288.25 Typical High $2,454.71 | Facility | None | $478.63 | $1,288.25 | $2,454.71 |
Aetna Setting Professional Modifier None Typical Low $457.09 Median $478.63 Typical High $537.03 | Professional | None | $457.09 | $478.63 | $537.03 |
BCBS Arkansas Setting Facility Modifier None Typical Low $3,090.30 Median $3,388.44 Typical High $4,677.35 | Facility | None | $3,090.30 | $3,388.44 | $4,677.35 |
BCBS Arkansas Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $537.03 | Professional | None | $407.38 | $407.38 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $2,511.89 Typical High $3,162.28 | Facility | None | $512.86 | $2,511.89 | $3,162.28 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $575.44 Typical High $831.76 | Professional | None | $338.84 | $575.44 | $831.76 |
United Setting Facility Modifier None Typical Low $1,096.48 Median $1,513.56 Typical High $5,011.87 | Facility | None | $1,096.48 | $1,513.56 | $5,011.87 |
United Setting Professional Modifier None Typical Low $354.81 Median $446.68 Typical High $794.33 | Professional | None | $354.81 | $446.68 | $794.33 |
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 $229.09 Median $239.88 Typical High $239.88 | Professional | 52 · Reduced service | $229.09 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $95.50 Typical High $95.50 | Professional | 53 · Discontinued | $91.20 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $354.81 Typical High $354.81 | Professional | 54 · Surgery only | $346.74 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $70.79 Typical High $70.79 | Professional | 55 · Aftercare only | $69.18 | $70.79 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $47.86 Typical High $47.86 | Professional | 56 · Pre-op care only | $45.71 | $47.86 | $47.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $331.13 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $323.59 | $331.13 | $331.13 |
Where Arkansas sits
The same service costs 5.4 times more in Alaska than in New York. 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· 5th of 51
$1,738
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.