How much rates vary
Facilitymedian $1,096 · 10th to 90th $468 to $1,698Professionalmedian $316 · 10th to 90th $240 to $407
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 $316.23 Median $1,288.25 Typical High $2,454.71 | Facility | None | $316.23 | $1,288.25 | $2,454.71 |
Aetna Setting Professional Modifier None Typical Low $245.47 Median $316.23 Typical High $354.81 | Professional | None | $245.47 | $316.23 | $354.81 |
BCBS Arkansas Setting Facility Modifier None Typical Low $616.60 Median $1,096.48 Typical High $1,513.56 | Facility | None | $616.60 | $1,096.48 | $1,513.56 |
BCBS Arkansas Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $346.74 | Professional | None | $263.03 | $263.03 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $616.60 Typical High $1,000.00 | Facility | None | $562.34 | $616.60 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $398.11 Typical High $512.86 | Professional | None | $181.97 | $398.11 | $512.86 |
United Setting Facility Modifier None Typical Low $407.38 Median $588.84 Typical High $1,995.26 | Facility | None | $407.38 | $588.84 | $1,995.26 |
United Setting Professional Modifier None Typical Low $229.09 Median $263.03 Typical High $489.78 | Professional | None | $229.09 | $263.03 | $489.78 |
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 $123.03 Median $154.88 Typical High $154.88 | Professional | 52 · Reduced service | $123.03 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $63.10 Typical High $63.10 | Professional | 53 · Discontinued | $48.98 | $63.10 | $63.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $234.42 Typical High $234.42 | Professional | 54 · Surgery only | $181.97 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $46.77 Typical High $46.77 | Professional | 55 · Aftercare only | $36.31 | $46.77 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $31.62 Typical High $31.62 | Professional | 56 · Pre-op care only | $24.55 | $31.62 | $31.62 |
Where Arkansas sits
The same service costs 5.6 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 $4,320MT $769
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.