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 $346.74 Median $1,230.27 Typical High $2,041.74 | Facility | None | $346.74 | $1,230.27 | $2,041.74 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $346.74 Typical High $389.05 | Professional | None | $281.84 | $346.74 | $389.05 |
Ambetter Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $380.19 | Professional | None | $380.19 | $380.19 | $380.19 |
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 $316.23 Median $316.23 Typical High $416.87 | Professional | None | $316.23 | $316.23 | $416.87 |
CareSource Setting Professional Modifier None Typical Low $257.04 Median $371.54 Typical High $380.19 | Professional | None | $257.04 | $371.54 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $2,630.27 Typical High $3,235.94 | Facility | None | $588.84 | $2,630.27 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $263.03 Median $269.15 Typical High $501.19 | Professional | None | $263.03 | $269.15 | $501.19 |
Qualchoice Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $436.52 | Professional | None | $436.52 | $436.52 | $436.52 |
United Setting Facility Modifier None Typical Low $794.33 Median $1,148.15 Typical High $3,388.44 | Facility | None | $794.33 | $1,148.15 | $3,388.44 |
United Setting Professional Modifier None Typical Low $257.04 Median $288.40 Typical High $537.03 | Professional | None | $257.04 | $288.40 | $537.03 |
8 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 $141.25 Median $169.82 Typical High $169.82 | Professional | 52 · Reduced service | $141.25 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $69.18 Typical High $69.18 | Professional | 53 · Discontinued | $56.23 | $69.18 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $257.04 Typical High $257.04 | Professional | 54 · Surgery only | $208.93 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $51.29 Typical High $51.29 | Professional | 55 · Aftercare only | $41.69 | $51.29 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $34.67 Typical High $34.67 | Professional | 56 · Pre-op care only | $28.18 | $34.67 | $34.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $239.88 Typical High $239.88 | Professional | 78 · Unplanned return to OR | $194.98 | $239.88 | $239.88 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $457.09 Median $457.09 Typical High $457.09 | Professional | GC · Resident with teaching physician | $457.09 | $457.09 | $457.09 |
Qualchoice Setting Professional Modifier GC · Resident with teaching physician Typical Low $537.03 Median $537.03 Typical High $537.03 | Professional | GC · Resident with teaching physician | $537.03 | $537.03 | $537.03 |
Where Arkansas sits
The same service costs 5.5 times more in Alaska than in Utah. 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· 27th of 51
$380
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.