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 $251.19 Median $1,000.00 Typical High $2,041.74 | Facility | None | $251.19 | $1,000.00 | $2,041.74 |
Aetna Setting Professional Modifier None Typical Low $251.19 Median $323.59 Typical High $371.54 | Professional | None | $251.19 | $323.59 | $371.54 |
BCBS Arkansas Setting Facility Modifier None Typical Low $263.03 Median $1,412.54 Typical High $1,949.84 | Facility | None | $263.03 | $1,412.54 | $1,949.84 |
BCBS Arkansas Setting Professional Modifier None Typical Low $234.42 Median $309.03 Typical High $489.78 | Professional | None | $234.42 | $309.03 | $489.78 |
Cigna Setting Facility Modifier None Typical Low $234.42 Median $281.84 Typical High $1,000.00 | Facility | None | $234.42 | $281.84 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $190.55 Median $269.15 Typical High $478.63 | Professional | None | $190.55 | $269.15 | $478.63 |
United Setting Facility Modifier None Typical Low $407.38 Median $588.84 Typical High $2,187.76 | Facility | None | $407.38 | $588.84 | $2,187.76 |
United Setting Professional Modifier None Typical Low $199.53 Median $302.00 Typical High $489.78 | Professional | None | $199.53 | $302.00 | $489.78 |
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 $125.89 Median $162.18 Typical High $186.21 | Professional | 52 · Reduced service | $125.89 | $162.18 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $64.57 Typical High $74.13 | Professional | 53 · Discontinued | $51.29 | $64.57 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $245.47 Typical High $275.42 | Professional | 54 · Surgery only | $190.55 | $245.47 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $48.98 Typical High $56.23 | Professional | 55 · Aftercare only | $38.02 | $48.98 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $32.36 Typical High $37.15 | Professional | 56 · Pre-op care only | $25.12 | $32.36 | $37.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $177.83 Median $229.09 Typical High $257.04 | Professional | 78 · Unplanned return to OR | $177.83 | $229.09 | $257.04 |
Where Arkansas sits
The same service costs 3.6 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· 38th of 51
$309
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.