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 $229.09 Median $1,230.27 Typical High $2,041.74 | Facility | None | $229.09 | $1,230.27 | $2,041.74 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $257.04 Typical High $338.84 | Professional | None | $229.09 | $257.04 | $338.84 |
Ambetter Setting Professional Modifier None Typical Low $323.59 Median $363.08 Typical High $363.08 | Professional | None | $323.59 | $363.08 | $363.08 |
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 $208.93 Median $269.15 Typical High $354.81 | Professional | None | $208.93 | $269.15 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $1,023.29 Typical High $1,258.93 | Facility | None | $562.34 | $1,023.29 | $1,258.93 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $354.81 Typical High $416.87 | Professional | None | $204.17 | $354.81 | $416.87 |
Qualchoice Setting Professional Modifier None Typical Low $363.08 Median $416.87 Typical High $416.87 | Professional | None | $363.08 | $416.87 | $416.87 |
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 $181.97 Median $234.42 Typical High $446.68 | Professional | None | $181.97 | $234.42 | $446.68 |
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 $114.82 Median $123.03 Typical High $141.25 | Professional | 52 · Reduced service | $114.82 | $123.03 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $50.12 Typical High $56.23 | Professional | 53 · Discontinued | $45.71 | $50.12 | $56.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $186.21 Typical High $208.93 | Professional | 54 · Surgery only | $173.78 | $186.21 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $37.15 Typical High $41.69 | Professional | 55 · Aftercare only | $34.67 | $37.15 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $24.55 Typical High $28.18 | Professional | 56 · Pre-op care only | $22.91 | $24.55 | $28.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $162.18 Median $173.78 Typical High $194.98 | Professional | 78 · Unplanned return to OR | $162.18 | $173.78 | $194.98 |
Where Arkansas sits
The same service costs 4.7 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· 21st of 51
$363
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.