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 $141.25 Median $1,174.90 Typical High $2,454.71 | Facility | None | $141.25 | $1,174.90 | $2,454.71 |
Aetna Setting Professional Modifier None Typical Low $134.90 Median $151.36 Typical High $177.83 | Professional | None | $134.90 | $151.36 | $177.83 |
BCBS Arkansas Setting Facility Modifier None Typical Low $181.97 Median $181.97 Typical High $251.19 | Facility | None | $181.97 | $181.97 | $251.19 |
BCBS Arkansas Setting Professional Modifier None Typical Low $112.20 Median $144.54 Typical High $194.98 | Professional | None | $112.20 | $144.54 | $194.98 |
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 $107.15 Median $181.97 Typical High $239.88 | Professional | None | $107.15 | $181.97 | $239.88 |
Qualchoice Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $204.17 | Professional | None | $204.17 | $204.17 | $204.17 |
United Setting Facility Modifier None Typical Low $79.43 Median $131.83 Typical High $707.95 | Facility | None | $79.43 | $131.83 | $707.95 |
United Setting Professional Modifier None Typical Low $93.33 Median $128.82 Typical High $245.47 | Professional | None | $93.33 | $128.82 | $245.47 |
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 $70.79 Median $70.79 Typical High $89.13 | Professional | 52 · Reduced service | $70.79 | $70.79 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $28.18 Typical High $35.48 | Professional | 53 · Discontinued | $28.18 | $28.18 | $35.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $107.15 Typical High $134.90 | Professional | 54 · Surgery only | $107.15 | $107.15 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $21.38 Typical High $26.92 | Professional | 55 · Aftercare only | $21.38 | $21.38 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $14.13 Typical High $17.78 | Professional | 56 · Pre-op care only | $14.13 | $14.13 | $17.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $100.00 Median $100.00 Typical High $125.89 | Professional | 78 · Unplanned return to OR | $100.00 | $100.00 | $125.89 |
Where Arkansas sits
The same service costs 4.1 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· 25th of 51
$174
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.