How much rates vary
Facilitymedian $3,548 · 10th to 90th $1,698 to $9,120Professionalmedian $1,585 · 10th to 90th $933 to $2,630
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 $1,174.90 Median $1,819.70 Typical High $2,818.38 | Facility | None | $1,174.90 | $1,819.70 | $2,818.38 |
Aetna Setting Professional Modifier None Typical Low $1,230.27 Median $1,548.82 Typical High $1,737.80 | Professional | None | $1,230.27 | $1,548.82 | $1,737.80 |
Ambetter Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $1,737.80 | Professional | None | $234.42 | $234.42 | $1,737.80 |
BCBS Arkansas Setting Facility Modifier None Typical Low $3,388.44 Median $6,760.83 Typical High $9,120.11 | Facility | None | $3,388.44 | $6,760.83 | $9,120.11 |
BCBS Arkansas Setting Professional Modifier None Typical Low $1,412.54 Median $1,584.89 Typical High $1,862.09 | Professional | None | $1,412.54 | $1,584.89 | $1,862.09 |
Cigna Setting Facility Modifier None Typical Low $1,122.02 Median $3,388.44 Typical High $4,168.69 | Facility | None | $1,122.02 | $3,388.44 | $4,168.69 |
Cigna Setting Professional Modifier None Typical Low $1,202.26 Median $2,630.27 Typical High $2,818.38 | Professional | None | $1,202.26 | $2,630.27 | $2,818.38 |
Qualchoice Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $1,995.26 | Professional | None | $269.15 | $269.15 | $1,995.26 |
United Setting Facility Modifier None Typical Low $1,659.59 Median $2,570.40 Typical High $9,120.11 | Facility | None | $1,659.59 | $2,570.40 | $9,120.11 |
United Setting Professional Modifier None Typical Low $1,071.52 Median $1,380.38 Typical High $2,630.27 | Professional | None | $1,071.52 | $1,380.38 | $2,630.27 |
10 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 $602.56 Median $776.25 Typical High $776.25 | Professional | 52 · Reduced service | $602.56 | $776.25 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $309.03 Typical High $309.03 | Professional | 53 · Discontinued | $239.88 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $1,174.90 Typical High $1,174.90 | Professional | 54 · Surgery only | $912.01 | $1,174.90 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $234.42 Typical High $234.42 | Professional | 55 · Aftercare only | $181.97 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $154.88 Typical High $154.88 | Professional | 56 · Pre-op care only | $120.23 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $1,096.48 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $851.14 | $1,096.48 | $1,096.48 |
Ambetter Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,737.80 Median $1,737.80 Typical High $1,737.80 | Professional | 78 · Unplanned return to OR | $1,737.80 | $1,737.80 | $1,737.80 |
Ambetter Setting Professional Modifier AS · PA/NP assist Typical Low $234.42 Median $234.42 Typical High $234.42 | Professional | AS · PA/NP assist | $234.42 | $234.42 | $234.42 |
Qualchoice Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,995.26 Median $1,995.26 Typical High $1,995.26 | Professional | 78 · Unplanned return to OR | $1,995.26 | $1,995.26 | $1,995.26 |
Qualchoice Setting Professional Modifier AS · PA/NP assist Typical Low $269.15 Median $269.15 Typical High $269.15 | Professional | AS · PA/NP assist | $269.15 | $269.15 | $269.15 |
Where Arkansas sits
The same service costs 4.7 times more in Colorado 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.
Physician feeFacility fee
CO $15,002KY $3,224
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.