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 $229.09 Median $691.83 Typical High $1,862.09 | Facility | None | $229.09 | $691.83 | $1,862.09 |
Aetna Setting Professional Modifier None Typical Low $213.80 Median $269.15 Typical High $354.81 | Professional | None | $213.80 | $269.15 | $354.81 |
Ambetter Setting Professional Modifier None Typical Low $239.88 Median $302.00 Typical High $309.03 | Professional | None | $239.88 | $302.00 | $309.03 |
BCBS Arkansas Setting Facility Modifier None Typical Low $213.80 Median $851.14 Typical High $1,148.15 | Facility | None | $213.80 | $851.14 | $1,148.15 |
BCBS Arkansas Setting Professional Modifier None Typical Low $204.17 Median $269.15 Typical High $398.11 | Professional | None | $204.17 | $269.15 | $398.11 |
CareSource Setting Professional Modifier None Typical Low $245.47 Median $354.81 Typical High $354.81 | Professional | None | $245.47 | $354.81 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $218.78 Median $257.04 Typical High $512.86 | Facility | None | $218.78 | $257.04 | $512.86 |
Cigna Setting Professional Modifier None Typical Low $208.93 Median $316.23 Typical High $446.68 | Professional | None | $208.93 | $316.23 | $446.68 |
Qualchoice Setting Professional Modifier None Typical Low $275.42 Median $346.74 Typical High $371.54 | Professional | None | $275.42 | $346.74 | $371.54 |
United Setting Facility Modifier None Typical Low $269.15 Median $363.08 Typical High $1,548.82 | Facility | None | $269.15 | $363.08 | $1,548.82 |
United Setting Professional Modifier None Typical Low $169.82 Median $245.47 Typical High $426.58 | Professional | None | $169.82 | $245.47 | $426.58 |
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 $109.65 Median $123.03 Typical High $158.49 | Professional | 52 · Reduced service | $109.65 | $123.03 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $48.98 Typical High $63.10 | Professional | 53 · Discontinued | $43.65 | $48.98 | $63.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $181.97 Typical High $234.42 | Professional | 54 · Surgery only | $162.18 | $181.97 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $37.15 Typical High $46.77 | Professional | 55 · Aftercare only | $32.36 | $37.15 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $24.55 Typical High $31.62 | Professional | 56 · Pre-op care only | $21.88 | $24.55 | $31.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $151.36 Median $169.82 Typical High $218.78 | Professional | 78 · Unplanned return to OR | $151.36 | $169.82 | $218.78 |
Where Arkansas sits
The same service costs 3.8 times more in Alaska than in Kentucky. 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· 30th of 51
$282
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.