How much rates vary
Facilitymedian $1,148 · 10th to 90th $589 to $2,754Professionalmedian $891 · 10th to 90th $708 to $1,380
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 $891.25 Median $1,698.24 Typical High $2,818.38 | Facility | None | $891.25 | $1,698.24 | $2,818.38 |
Aetna Setting Professional Modifier None Typical Low $851.14 Median $891.25 Typical High $977.24 | Professional | None | $851.14 | $891.25 | $977.24 |
Ambetter Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,148.15 | Professional | None | $1,148.15 | $1,148.15 | $1,148.15 |
BCBS Arkansas Setting Facility Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,584.89 | Facility | None | $1,148.15 | $1,148.15 | $1,584.89 |
BCBS Arkansas Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $1,071.52 | Professional | None | $794.33 | $794.33 | $1,071.52 |
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 $588.84 Median $1,230.27 Typical High $1,380.38 | Professional | None | $588.84 | $1,230.27 | $1,380.38 |
Qualchoice Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,318.26 | Professional | None | $1,318.26 | $1,318.26 | $1,318.26 |
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 $676.08 Median $831.76 Typical High $1,548.82 | Professional | None | $676.08 | $831.76 | $1,548.82 |
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 $446.68 Median $446.68 Typical High $478.63 | Professional | 52 · Reduced service | $446.68 | $446.68 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $177.83 Typical High $190.55 | Professional | 53 · Discontinued | $177.83 | $177.83 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $676.08 Typical High $724.44 | Professional | 54 · Surgery only | $660.69 | $676.08 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $134.90 Typical High $144.54 | Professional | 55 · Aftercare only | $134.90 | $134.90 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $89.13 Typical High $95.50 | Professional | 56 · Pre-op care only | $89.13 | $89.13 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $630.96 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $616.60 | $630.96 | $676.08 |
Where Arkansas sits
The same service costs 11.6 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 $23,484TX $2,029
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.