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 $416.87 Median $1,071.52 Typical High $2,041.74 | Facility | None | $416.87 | $1,071.52 | $2,041.74 |
Aetna Setting Professional Modifier None Typical Low $416.87 Median $436.52 Typical High $537.03 | Professional | None | $416.87 | $436.52 | $537.03 |
BCBS Arkansas Setting Facility Modifier None Typical Low $2,754.23 Median $5,370.32 Typical High $7,413.10 | Facility | None | $2,754.23 | $5,370.32 | $7,413.10 |
BCBS Arkansas Setting Professional Modifier None Typical Low $346.74 Median $457.09 Typical High $630.96 | Professional | None | $346.74 | $457.09 | $630.96 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $2,630.27 Typical High $3,235.94 | Facility | None | $512.86 | $2,630.27 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $407.38 Typical High $660.69 | Professional | None | $309.03 | $407.38 | $660.69 |
United Setting Facility Modifier None Typical Low $794.33 Median $1,122.02 Typical High $3,388.44 | Facility | None | $794.33 | $1,122.02 | $3,388.44 |
United Setting Professional Modifier None Typical Low $316.23 Median $426.58 Typical High $724.44 | Professional | None | $316.23 | $426.58 | $724.44 |
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 $204.17 Median $218.78 Typical High $269.15 | Professional | 52 · Reduced service | $204.17 | $218.78 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $87.10 Typical High $109.65 | Professional | 53 · Discontinued | $83.18 | $87.10 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $323.59 Typical High $407.38 | Professional | 54 · Surgery only | $309.03 | $323.59 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $64.57 Typical High $81.28 | Professional | 55 · Aftercare only | $61.66 | $64.57 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $43.65 Typical High $53.70 | Professional | 56 · Pre-op care only | $41.69 | $43.65 | $53.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $302.00 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $288.40 | $302.00 | $380.19 |
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· 34th of 51
$457
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.