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 $134.90 Median $1,174.90 Typical High $2,454.71 | Facility | None | $134.90 | $1,174.90 | $2,454.71 |
Aetna Setting Professional Modifier None Typical Low $134.90 Median $177.83 Typical High $213.80 | Professional | None | $134.90 | $177.83 | $213.80 |
BCBS Arkansas Setting Facility Modifier None Typical Low $831.76 Median $831.76 Typical High $1,148.15 | Facility | None | $831.76 | $831.76 | $1,148.15 |
BCBS Arkansas Setting Professional Modifier None Typical Low $123.03 Median $162.18 Typical High $263.03 | Professional | None | $123.03 | $162.18 | $263.03 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $100.00 Typical High $512.86 | Facility | None | $50.12 | $100.00 | $512.86 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $190.55 Typical High $316.23 | Professional | None | $117.49 | $190.55 | $316.23 |
United Setting Facility Modifier None Typical Low $407.38 Median $588.84 Typical High $1,995.26 | Facility | None | $407.38 | $588.84 | $1,995.26 |
United Setting Professional Modifier None Typical Low $109.65 Median $186.21 Typical High $354.81 | Professional | None | $109.65 | $186.21 | $354.81 |
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 $67.61 Median $87.10 Typical High $107.15 | Professional | 52 · Reduced service | $67.61 | $87.10 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $34.67 Typical High $42.66 | Professional | 53 · Discontinued | $26.92 | $34.67 | $42.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $102.33 Median $128.82 Typical High $162.18 | Professional | 54 · Surgery only | $102.33 | $128.82 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $25.70 Typical High $32.36 | Professional | 55 · Aftercare only | $20.42 | $25.70 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $17.38 Typical High $21.38 | Professional | 56 · Pre-op care only | $13.49 | $17.38 | $21.38 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $95.50 Median $120.23 Typical High $151.36 | Professional | 78 · Unplanned return to OR | $95.50 | $120.23 | $151.36 |
Where Arkansas sits
The same service costs 3.8 times more in Wisconsin than in Hawaii. 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· 28th of 51
$214
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.