How much rates vary
Facilitymedian $3,467 · 10th to 90th $589 to $9,550Professionalmedian $1,318 · 10th to 90th $1,096 to $2,042
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 $1,071.52 Median $1,513.56 Typical High $2,454.71 | Facility | None | $1,071.52 | $1,513.56 | $2,454.71 |
Aetna Setting Professional Modifier None Typical Low $1,258.93 Median $1,318.26 Typical High $1,513.56 | Professional | None | $1,258.93 | $1,318.26 | $1,513.56 |
BCBS Arkansas Setting Facility Modifier None Typical Low $7,079.46 Median $7,079.46 Typical High $9,549.93 | Facility | None | $7,079.46 | $7,079.46 | $9,549.93 |
BCBS Arkansas Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,479.11 | Professional | None | $1,122.02 | $1,122.02 | $1,479.11 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $501.19 Typical High $1,023.29 | Facility | None | $501.19 | $501.19 | $1,023.29 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $1,862.09 Typical High $2,041.74 | Professional | None | $851.14 | $1,862.09 | $2,041.74 |
United Setting Facility Modifier None Typical Low $1,096.48 Median $1,513.56 Typical High $3,801.89 | Facility | None | $1,096.48 | $1,513.56 | $3,801.89 |
United Setting Professional Modifier None Typical Low $1,047.13 Median $1,202.26 Typical High $2,187.76 | Professional | None | $1,047.13 | $1,202.26 | $2,187.76 |
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 $645.65 Median $660.69 Typical High $707.95 | Professional | 52 · Reduced service | $645.65 | $660.69 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $263.03 Typical High $281.84 | Professional | 53 · Discontinued | $263.03 | $263.03 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $1,000.00 Typical High $1,047.13 | Professional | 54 · Surgery only | $977.24 | $1,000.00 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $199.53 Typical High $213.80 | Professional | 55 · Aftercare only | $194.98 | $199.53 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $131.83 Typical High $141.25 | Professional | 56 · Pre-op care only | $128.82 | $131.83 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $933.25 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $912.01 | $933.25 | $977.24 |
Where Arkansas sits
The same service costs 9.2 times more in Maine than in Texas. 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
ME $22,965TX $2,508
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.