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 $588.84 Median $1,513.56 Typical High $2,454.71 | Facility | None | $588.84 | $1,513.56 | $2,454.71 |
Aetna Setting Professional Modifier None Typical Low $467.74 Median $588.84 Typical High $616.60 | Professional | None | $467.74 | $588.84 | $616.60 |
BCBS Setting Facility Modifier None Typical Low $1,621.81 Median $3,235.94 Typical High $4,466.84 | Facility | None | $1,621.81 | $3,235.94 | $4,466.84 |
BCBS Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $602.56 | Professional | None | $457.09 | $457.09 | $602.56 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $1,548.82 Typical High $1,949.84 | Facility | None | $691.83 | $1,548.82 | $1,949.84 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $616.60 Typical High $1,000.00 | Professional | None | $338.84 | $616.60 | $1,000.00 |
United Setting Facility Modifier None Typical Low $794.33 Median $1,122.02 Typical High $3,388.44 | Facility | None | $794.33 | $1,122.02 | $3,388.44 |
United Setting Professional Modifier None Typical Low $407.38 Median $467.74 Typical High $851.14 | Professional | None | $407.38 | $467.74 | $851.14 |
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 $288.40 Median $295.12 Typical High $295.12 | Professional | 52 · Reduced service | $288.40 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $120.23 Typical High $120.23 | Professional | 53 · Discontinued | $114.82 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $446.68 Typical High $446.68 | Professional | 54 · Surgery only | $426.58 | $446.68 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $89.13 Typical High $89.13 | Professional | 55 · Aftercare only | $87.10 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $58.88 Typical High $58.88 | Professional | 56 · Pre-op care only | $57.54 | $58.88 | $58.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $416.87 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $398.11 | $416.87 | $416.87 |
Where Arkansas sits
The same service costs 8.9 times more in Oklahoma than in Utah. 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· 11th of 51
$1,000
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.