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 $48.98 Median $1,000.00 Typical High $2,041.74 | Facility | None | $48.98 | $1,000.00 | $2,041.74 |
Aetna Setting Professional Modifier None Typical Low $48.98 Median $128.82 Typical High $177.83 | Professional | None | $48.98 | $128.82 | $177.83 |
BCBS Arkansas Setting Facility Modifier None Typical Low $851.14 Median $851.14 Typical High $1,148.15 | Facility | None | $851.14 | $851.14 | $1,148.15 |
BCBS Arkansas Setting Professional Modifier None Typical Low $43.65 Median $57.54 Typical High $223.87 | Professional | None | $43.65 | $57.54 | $223.87 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $100.00 Typical High $512.86 | Facility | None | $50.12 | $100.00 | $512.86 |
Cigna Setting Professional Modifier None Typical Low $50.12 Median $112.20 Typical High $245.47 | Professional | None | $50.12 | $112.20 | $245.47 |
United Setting Facility Modifier None Typical Low $269.15 Median $389.05 Typical High $1,548.82 | Facility | None | $269.15 | $389.05 | $1,548.82 |
United Setting Professional Modifier None Typical Low $37.15 Median $91.20 Typical High $213.80 | Professional | None | $37.15 | $91.20 | $213.80 |
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 $23.99 Median $36.31 Typical High $89.13 | Professional | 52 · Reduced service | $23.99 | $36.31 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.77 Median $14.45 Typical High $35.48 | Professional | 53 · Discontinued | $9.77 | $14.45 | $35.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $36.31 Median $53.70 Typical High $134.90 | Professional | 54 · Surgery only | $36.31 | $53.70 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.24 Median $10.72 Typical High $26.92 | Professional | 55 · Aftercare only | $7.24 | $10.72 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $7.24 Typical High $17.78 | Professional | 56 · Pre-op care only | $4.79 | $7.24 | $17.78 |
Where Arkansas sits
The same service costs 4.6 times more in Wisconsin than in Washington, DC. 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· 26th of 51
$132
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.