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 $1,000.00 Typical High $2,041.74 | Facility | None | $416.87 | $1,000.00 | $2,041.74 |
Aetna Setting Professional Modifier None Typical Low $416.87 Median $489.78 Typical High $562.34 | Professional | None | $416.87 | $489.78 | $562.34 |
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 $380.19 Median $501.19 Typical High $758.58 | Professional | None | $380.19 | $501.19 | $758.58 |
Cigna Setting Facility Modifier None Typical Low $380.19 Median $1,288.25 Typical High $1,659.59 | Facility | None | $380.19 | $1,288.25 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $426.58 Typical High $724.44 | Professional | None | $316.23 | $426.58 | $724.44 |
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 $323.59 Median $457.09 Typical High $776.25 | Professional | None | $323.59 | $457.09 | $776.25 |
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 $245.47 Typical High $281.84 | Professional | 52 · Reduced service | $204.17 | $245.47 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $97.72 Typical High $112.20 | Professional | 53 · Discontinued | $83.18 | $97.72 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $371.54 Typical High $416.87 | Professional | 54 · Surgery only | $309.03 | $371.54 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $74.13 Typical High $83.18 | Professional | 55 · Aftercare only | $61.66 | $74.13 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $48.98 Typical High $56.23 | Professional | 56 · Pre-op care only | $41.69 | $48.98 | $56.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $346.74 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $288.40 | $346.74 | $389.05 |
Where Arkansas sits
The same service costs 3.7 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· 35th of 51
$501
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.