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 $331.13 Median $1,071.52 Typical High $2,041.74 | Facility | None | $331.13 | $1,071.52 | $2,041.74 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $338.84 Typical High $426.58 | Professional | None | $316.23 | $338.84 | $426.58 |
BCBS Arkansas Setting Facility Modifier None Typical Low $1,318.26 Median $2,884.03 Typical High $3,981.07 | Facility | None | $1,318.26 | $2,884.03 | $3,981.07 |
BCBS Arkansas Setting Professional Modifier None Typical Low $281.84 Median $371.54 Typical High $501.19 | Professional | None | $281.84 | $371.54 | $501.19 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $1,288.25 Typical High $1,659.59 | Facility | None | $512.86 | $1,288.25 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $251.19 Median $323.59 Typical High $512.86 | Professional | None | $251.19 | $323.59 | $512.86 |
United Setting Facility Modifier None Typical Low $407.38 Median $588.84 Typical High $2,511.89 | Facility | None | $407.38 | $588.84 | $2,511.89 |
United Setting Professional Modifier None Typical Low $251.19 Median $331.13 Typical High $575.44 | Professional | None | $251.19 | $331.13 | $575.44 |
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 $165.96 Median $169.82 Typical High $213.80 | Professional | 52 · Reduced service | $165.96 | $169.82 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $67.61 Typical High $85.11 | Professional | 53 · Discontinued | $66.07 | $67.61 | $85.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $257.04 Typical High $323.59 | Professional | 54 · Surgery only | $251.19 | $257.04 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $51.29 Typical High $64.57 | Professional | 55 · Aftercare only | $50.12 | $51.29 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $33.88 Typical High $42.66 | Professional | 56 · Pre-op care only | $33.11 | $33.88 | $42.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $239.88 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $234.42 | $239.88 | $302.00 |
Where Arkansas sits
The same service costs 4.1 times more in Alaska than in New Jersey. 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· 31st of 51
$372
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.