How much rates vary
Facilitymedian $1,995 · 10th to 90th $912 to $4,169Professionalmedian $550 · 10th to 90th $182 to $1,122
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 $223.87 Median $1,071.52 Typical High $2,041.74 | Facility | None | $223.87 | $1,071.52 | $2,041.74 |
Aetna Setting Professional Modifier None Typical Low $208.93 Median $602.56 Typical High $870.96 | Professional | None | $208.93 | $602.56 | $870.96 |
Ambetter Setting Professional Modifier None Typical Low $67.61 Median $208.93 Typical High $281.84 | Professional | None | $67.61 | $208.93 | $281.84 |
BCBS Arkansas Setting Facility Modifier None Typical Low $1,995.26 Median $3,019.95 Typical High $4,168.69 | Facility | None | $1,995.26 | $3,019.95 | $4,168.69 |
BCBS Arkansas Setting Professional Modifier None Typical Low $181.97 Median $239.88 Typical High $1,000.00 | Professional | None | $181.97 | $239.88 | $1,000.00 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $1,862.09 Typical High $2,290.87 | Facility | None | $512.86 | $1,862.09 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $239.88 Median $354.81 Typical High $1,258.93 | Professional | None | $239.88 | $354.81 | $1,258.93 |
Qualchoice Setting Professional Modifier None Typical Low $281.84 Median $323.59 Typical High $407.38 | Professional | None | $281.84 | $323.59 | $407.38 |
United Setting Facility Modifier None Typical Low $1,096.48 Median $1,513.56 Typical High $4,466.84 | Facility | None | $1,096.48 | $1,513.56 | $4,466.84 |
United Setting Professional Modifier None Typical Low $190.55 Median $707.95 Typical High $1,412.54 | Professional | None | $190.55 | $707.95 | $1,412.54 |
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 $112.20 Median $154.88 Typical High $407.38 | Professional | 52 · Reduced service | $112.20 | $154.88 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $61.66 Typical High $162.18 | Professional | 53 · Discontinued | $44.67 | $61.66 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $234.42 Typical High $616.60 | Professional | 54 · Surgery only | $169.82 | $234.42 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $46.77 Typical High $123.03 | Professional | 55 · Aftercare only | $33.88 | $46.77 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $30.90 Typical High $81.28 | Professional | 56 · Pre-op care only | $22.39 | $30.90 | $81.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $158.49 Median $218.78 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $158.49 | $218.78 | $575.44 |
Where Arkansas sits
The same service costs 5.1 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 $7,315MT $1,443
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.