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 $1,380.38 Typical High $2,818.38 | Facility | None | $229.09 | $1,380.38 | $2,818.38 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $239.88 Typical High $251.19 | Professional | None | $229.09 | $239.88 | $251.19 |
BCBS Arkansas Setting Facility Modifier None Typical Low $1,584.89 Median $2,884.03 Typical High $3,981.07 | Facility | None | $1,584.89 | $2,884.03 | $3,981.07 |
BCBS Arkansas Setting Professional Modifier None Typical Low $218.78 Median $245.47 Typical High $323.59 | Professional | None | $218.78 | $245.47 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $1,584.89 Typical High $1,949.84 | Facility | None | $831.76 | $1,584.89 | $1,949.84 |
Cigna Setting Professional Modifier None Typical Low $190.55 Median $323.59 Typical High $354.81 | Professional | None | $190.55 | $323.59 | $354.81 |
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 $190.55 Median $223.87 Typical High $426.58 | Professional | None | $190.55 | $223.87 | $426.58 |
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 $114.82 Typical High $120.23 | Professional | 52 · Reduced service | $114.82 | $114.82 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $46.77 Typical High $47.86 | Professional | 53 · Discontinued | $45.71 | $46.77 | $47.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $173.78 Typical High $181.97 | Professional | 54 · Surgery only | $173.78 | $173.78 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $34.67 Typical High $36.31 | Professional | 55 · Aftercare only | $34.67 | $34.67 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $22.91 Typical High $23.99 | Professional | 56 · Pre-op care only | $22.91 | $22.91 | $23.99 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $162.18 Median $162.18 Typical High $169.82 | Professional | 78 · Unplanned return to OR | $162.18 | $162.18 | $169.82 |
Where Arkansas sits
The same service costs 4.6 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· 22nd of 51
$339
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.