How much rates vary
Facilitymedian $1,096 · 10th to 90th $417 to $2,399Professionalmedian $195 · 10th to 90th $135 to $295
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 $169.82 Median $1,000.00 Typical High $2,041.74 | Facility | None | $169.82 | $1,000.00 | $2,041.74 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $181.97 Typical High $229.09 | Professional | None | $169.82 | $181.97 | $229.09 |
BCBS Arkansas Setting Facility Modifier None Typical Low $954.99 Median $1,737.80 Typical High $2,398.83 | Facility | None | $954.99 | $1,737.80 | $2,398.83 |
BCBS Arkansas Setting Professional Modifier None Typical Low $134.90 Median $177.83 Typical High $263.03 | Professional | None | $134.90 | $177.83 | $263.03 |
Cigna Setting Facility Modifier None Typical Low $380.19 Median $977.24 Typical High $1,258.93 | Facility | None | $380.19 | $977.24 | $1,258.93 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $229.09 Typical High $323.59 | Professional | None | $144.54 | $229.09 | $323.59 |
United Setting Facility Modifier None Typical Low $407.38 Median $588.84 Typical High $2,511.89 | Facility | None | $407.38 | $588.84 | $2,511.89 |
United Setting Professional Modifier None Typical Low $117.49 Median $181.97 Typical High $338.84 | Professional | None | $117.49 | $181.97 | $338.84 |
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 $85.11 Median $89.13 Typical High $114.82 | Professional | 52 · Reduced service | $85.11 | $89.13 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $36.31 Typical High $45.71 | Professional | 53 · Discontinued | $33.88 | $36.31 | $45.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $134.90 Typical High $173.78 | Professional | 54 · Surgery only | $125.89 | $134.90 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $26.92 Typical High $34.67 | Professional | 55 · Aftercare only | $25.70 | $26.92 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $17.78 Typical High $22.91 | Professional | 56 · Pre-op care only | $16.98 | $17.78 | $22.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $117.49 Median $125.89 Typical High $162.18 | Professional | 78 · Unplanned return to OR | $117.49 | $125.89 | $162.18 |
Where Arkansas sits
The same service costs 9.9 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 $4,605MT $466
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.