How much rates vary
Facilitymedian $1,380 · 10th to 90th $851 to $2,570Professionalmedian $427 · 10th to 90th $309 to $575
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 $416.87 Median $1,513.56 Typical High $2,454.71 | Facility | None | $416.87 | $1,513.56 | $2,454.71 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $416.87 Typical High $467.74 | Professional | None | $331.13 | $416.87 | $467.74 |
Ambetter Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $446.68 | Professional | None | $446.68 | $446.68 | $446.68 |
BCBS Arkansas Setting Facility Modifier None Typical Low $933.25 Median $1,905.46 Typical High $2,570.40 | Facility | None | $933.25 | $1,905.46 | $2,570.40 |
BCBS Arkansas Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $436.52 | Professional | None | $323.59 | $323.59 | $436.52 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $933.25 Typical High $1,174.90 | Facility | None | $691.83 | $933.25 | $1,174.90 |
Cigna Setting Professional Modifier None Typical Low $239.88 Median $436.52 Typical High $707.95 | Professional | None | $239.88 | $436.52 | $707.95 |
Qualchoice Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $512.86 | Professional | None | $512.86 | $512.86 | $512.86 |
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 $288.40 Median $331.13 Typical High $616.60 | Professional | None | $288.40 | $331.13 | $616.60 |
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 $208.93 Median $208.93 Typical High $218.78 | Professional | 52 · Reduced service | $208.93 | $208.93 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $85.11 Typical High $87.10 | Professional | 53 · Discontinued | $83.18 | $85.11 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $316.23 Typical High $323.59 | Professional | 54 · Surgery only | $309.03 | $316.23 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $63.10 Typical High $64.57 | Professional | 55 · Aftercare only | $61.66 | $63.10 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $41.69 Typical High $43.65 | Professional | 56 · Pre-op care only | $41.69 | $41.69 | $43.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $295.12 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $288.40 | $295.12 | $302.00 |
Where Arkansas sits
The same service costs 5.1 times more in Oklahoma 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
OK $5,094MT $991
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.