How much rates vary
Facilitymedian $1,000 · 10th to 90th $245 to $1,698Professionalmedian $170 · 10th to 90th $79 to $389
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 $91.20 Median $1,000.00 Typical High $2,041.74 | Facility | None | $91.20 | $1,000.00 | $2,041.74 |
Aetna Setting Professional Modifier None Typical Low $89.13 Median $218.78 Typical High $263.03 | Professional | None | $89.13 | $218.78 | $263.03 |
Ambetter Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | None | $120.23 | $120.23 | $120.23 |
BCBS Arkansas Setting Facility Modifier None Typical Low $245.47 Median $1,096.48 Typical High $1,513.56 | Facility | None | $245.47 | $1,096.48 | $1,513.56 |
BCBS Arkansas Setting Professional Modifier None Typical Low $79.43 Median $104.71 Typical High $389.05 | Professional | None | $79.43 | $104.71 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $239.88 Median $281.84 Typical High $1,000.00 | Facility | None | $239.88 | $281.84 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $89.13 Median $190.55 Typical High $389.05 | Professional | None | $89.13 | $190.55 | $389.05 |
Qualchoice Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | None | $138.04 | $138.04 | $138.04 |
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 $69.18 Median $181.97 Typical High $331.13 | Professional | None | $69.18 | $181.97 | $331.13 |
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 $44.67 Median $75.86 Typical High $131.83 | Professional | 52 · Reduced service | $44.67 | $75.86 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $30.20 Typical High $52.48 | Professional | 53 · Discontinued | $17.78 | $30.20 | $52.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $66.07 Median $114.82 Typical High $199.53 | Professional | 54 · Surgery only | $66.07 | $114.82 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $22.91 Typical High $39.81 | Professional | 55 · Aftercare only | $13.18 | $22.91 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $15.14 Typical High $26.30 | Professional | 56 · Pre-op care only | $8.91 | $15.14 | $26.30 |
Where Arkansas sits
The same service costs 9.0 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 $4,579MT $507
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.