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 $162.18 Median $1,000.00 Typical High $2,041.74 | Facility | None | $162.18 | $1,000.00 | $2,041.74 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $223.87 Typical High $281.84 | Professional | None | $162.18 | $223.87 | $281.84 |
BCBS Arkansas Setting Facility Modifier None Typical Low $186.21 Median $380.19 Typical High $524.81 | Facility | None | $186.21 | $380.19 | $524.81 |
BCBS Arkansas Setting Professional Modifier None Typical Low $147.91 Median $194.98 Typical High $338.84 | Professional | None | $147.91 | $194.98 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $181.97 Median $213.80 Typical High $512.86 | Facility | None | $181.97 | $213.80 | $512.86 |
Cigna Setting Professional Modifier None Typical Low $169.82 Median $239.88 Typical High $371.54 | Professional | None | $169.82 | $239.88 | $371.54 |
United Setting Facility Modifier None Typical Low $79.43 Median $131.83 Typical High $741.31 | Facility | None | $79.43 | $131.83 | $741.31 |
United Setting Professional Modifier None Typical Low $125.89 Median $213.80 Typical High $331.13 | Professional | None | $125.89 | $213.80 | $331.13 |
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 $81.28 Median $109.65 Typical High $141.25 | Professional | 52 · Reduced service | $81.28 | $109.65 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $43.65 Typical High $56.23 | Professional | 53 · Discontinued | $33.11 | $43.65 | $56.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $165.96 Typical High $213.80 | Professional | 54 · Surgery only | $123.03 | $165.96 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $33.11 Typical High $42.66 | Professional | 55 · Aftercare only | $24.55 | $33.11 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $21.88 Typical High $28.18 | Professional | 56 · Pre-op care only | $16.22 | $21.88 | $28.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $114.82 Median $154.88 Typical High $199.53 | Professional | 78 · Unplanned return to OR | $114.82 | $154.88 | $199.53 |
Where Arkansas sits
The same service costs 3.5 times more in Alaska 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· 34th of 51
$219
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.