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 $173.78 Median $1,000.00 Typical High $2,041.74 | Facility | None | $173.78 | $1,000.00 | $2,041.74 |
Aetna Setting Professional Modifier None Typical Low $173.78 Median $218.78 Typical High $269.15 | Professional | None | $173.78 | $218.78 | $269.15 |
BCBS Arkansas Setting Facility Modifier None Typical Low $190.55 Median $2,884.03 Typical High $3,981.07 | Facility | None | $190.55 | $2,884.03 | $3,981.07 |
BCBS Arkansas Setting Professional Modifier None Typical Low $151.36 Median $199.53 Typical High $316.23 | Professional | None | $151.36 | $199.53 | $316.23 |
Cigna Setting Facility Modifier None Typical Low $151.36 Median $186.21 Typical High $575.44 | Facility | None | $151.36 | $186.21 | $575.44 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $204.17 Typical High $354.81 | Professional | None | $131.83 | $204.17 | $354.81 |
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 $134.90 Median $213.80 Typical High $338.84 | Professional | None | $134.90 | $213.80 | $338.84 |
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 $87.10 Median $109.65 Typical High $134.90 | Professional | 52 · Reduced service | $87.10 | $109.65 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $43.65 Typical High $53.70 | Professional | 53 · Discontinued | $34.67 | $43.65 | $53.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $162.18 Typical High $204.17 | Professional | 54 · Surgery only | $131.83 | $162.18 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $32.36 Typical High $40.74 | Professional | 55 · Aftercare only | $26.30 | $32.36 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $21.88 Typical High $26.92 | Professional | 56 · Pre-op care only | $17.38 | $21.88 | $26.92 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $123.03 Median $151.36 Typical High $190.55 | Professional | 78 · Unplanned return to OR | $123.03 | $151.36 | $190.55 |
Where Arkansas sits
The same service costs 3.5 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
$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.