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 $131.83 Median $1,000.00 Typical High $2,041.74 | Facility | None | $131.83 | $1,000.00 | $2,041.74 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $134.90 Typical High $173.78 | Professional | None | $123.03 | $134.90 | $173.78 |
Ambetter Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $147.91 | Professional | None | $147.91 | $147.91 | $147.91 |
BCBS Arkansas Setting Facility Modifier None Typical Low $112.20 Median $1,412.54 Typical High $1,949.84 | Facility | None | $112.20 | $1,412.54 | $1,949.84 |
BCBS Arkansas Setting Professional Modifier None Typical Low $117.49 Median $154.88 Typical High $204.17 | Professional | None | $117.49 | $154.88 | $204.17 |
Cigna Setting Facility Modifier None Typical Low $91.20 Median $107.15 Typical High $512.86 | Facility | None | $91.20 | $107.15 | $512.86 |
Cigna Setting Professional Modifier None Typical Low $97.72 Median $131.83 Typical High $218.78 | Professional | None | $97.72 | $131.83 | $218.78 |
Qualchoice Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $169.82 | Professional | None | $169.82 | $169.82 | $169.82 |
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 $100.00 Median $138.04 Typical High $239.88 | Professional | None | $100.00 | $138.04 | $239.88 |
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 $64.57 Median $67.61 Typical High $87.10 | Professional | 52 · Reduced service | $64.57 | $67.61 | $87.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $26.92 Typical High $34.67 | Professional | 53 · Discontinued | $26.30 | $26.92 | $34.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $102.33 Typical High $131.83 | Professional | 54 · Surgery only | $97.72 | $102.33 | $131.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $20.42 Typical High $26.30 | Professional | 55 · Aftercare only | $19.50 | $20.42 | $26.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $13.49 Typical High $17.38 | Professional | 56 · Pre-op care only | $13.18 | $13.49 | $17.38 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $91.20 Median $95.50 Typical High $123.03 | Professional | 78 · Unplanned return to OR | $91.20 | $95.50 | $123.03 |
Where Arkansas sits
The same service costs 4.0 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· 32nd of 51
$155
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.