How much rates vary
Facilitymedian $1,000 · 10th to 90th $417 to $2,455Professionalmedian $234 · 10th to 90th $138 to $537
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 $158.49 Median $1,000.00 Typical High $2,454.71 | Facility | None | $158.49 | $1,000.00 | $2,454.71 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $263.03 Typical High $363.08 | Professional | None | $158.49 | $263.03 | $363.08 |
BCBS Arkansas Setting Facility Modifier None Typical Low $831.76 Median $1,778.28 Typical High $2,454.71 | Facility | None | $831.76 | $1,778.28 | $2,454.71 |
BCBS Arkansas Setting Professional Modifier None Typical Low $138.04 Median $181.97 Typical High $537.03 | Professional | None | $138.04 | $181.97 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $380.19 Median $794.33 Typical High $977.24 | Facility | None | $380.19 | $794.33 | $977.24 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $245.47 Typical High $562.34 | Professional | None | $165.96 | $245.47 | $562.34 |
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 $123.03 Median $204.17 Typical High $501.19 | Professional | None | $123.03 | $204.17 | $501.19 |
5 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 $79.43 Median $100.00 Typical High $181.97 | Professional | 52 · Reduced service | $79.43 | $100.00 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $39.81 Typical High $72.44 | Professional | 53 · Discontinued | $31.62 | $39.81 | $72.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $147.91 Typical High $275.42 | Professional | 54 · Surgery only | $120.23 | $147.91 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $30.20 Typical High $54.95 | Professional | 55 · Aftercare only | $23.99 | $30.20 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $19.95 Typical High $36.31 | Professional | 56 · Pre-op care only | $15.85 | $19.95 | $36.31 |
Where Arkansas sits
The same service costs 5.7 times more in Colorado than in Montana. 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.
Physician feeFacility fee
CO $4,090MT $722
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.