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 $109.65 Median $1,174.90 Typical High $2,454.71 | Facility | None | $109.65 | $1,174.90 | $2,454.71 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $114.82 Typical High $138.04 | Professional | None | $109.65 | $114.82 | $138.04 |
BCBS Arkansas Setting Facility Modifier None Typical Low $81.28 Median $218.78 Typical High $302.00 | Facility | None | $81.28 | $218.78 | $302.00 |
BCBS Arkansas Setting Professional Modifier None Typical Low $89.13 Median $117.49 Typical High $154.88 | Professional | None | $89.13 | $117.49 | $154.88 |
Cigna Setting Facility Modifier None Typical Low $74.13 Median $87.10 Typical High $512.86 | Facility | None | $74.13 | $87.10 | $512.86 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $141.25 Typical High $190.55 | Professional | None | $85.11 | $141.25 | $190.55 |
Qualchoice Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $218.78 | Professional | None | $218.78 | $218.78 | $218.78 |
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 $77.62 Median $109.65 Typical High $186.21 | Professional | None | $77.62 | $109.65 | $186.21 |
7 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 $53.70 Median $56.23 Typical High $69.18 | Professional | 52 · Reduced service | $53.70 | $56.23 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $22.39 Typical High $27.54 | Professional | 53 · Discontinued | $21.88 | $22.39 | $27.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $85.11 Typical High $102.33 | Professional | 54 · Surgery only | $81.28 | $85.11 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $16.98 Typical High $20.89 | Professional | 55 · Aftercare only | $16.22 | $16.98 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $11.22 Typical High $13.80 | Professional | 56 · Pre-op care only | $10.96 | $11.22 | $13.80 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $75.86 Median $79.43 Typical High $95.50 | Professional | 78 · Unplanned return to OR | $75.86 | $79.43 | $95.50 |
Ambetter Setting Professional Modifier 58 · Staged procedure Typical Low $199.53 Median $199.53 Typical High $199.53 | Professional | 58 · Staged procedure | $199.53 | $199.53 | $199.53 |
Where Arkansas sits
The same service costs 3.3 times more in Alaska than in Pennsylvania. 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· 31st of 51
$129
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.