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 $234.42 Median $1,071.52 Typical High $2,041.74 | Facility | None | $234.42 | $1,071.52 | $2,041.74 |
Aetna Setting Professional Modifier None Typical Low $234.42 Median $239.88 Typical High $275.42 | Professional | None | $234.42 | $239.88 | $275.42 |
BCBS Arkansas Setting Facility Modifier None Typical Low $478.63 Median $870.96 Typical High $1,174.90 | Facility | None | $478.63 | $870.96 | $1,174.90 |
BCBS Arkansas Setting Professional Modifier None Typical Low $213.80 Median $281.84 Typical High $380.19 | Professional | None | $213.80 | $281.84 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $489.78 Typical High $724.44 | Facility | None | $436.52 | $489.78 | $724.44 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $398.11 Typical High $478.63 | Professional | None | $204.17 | $398.11 | $478.63 |
United Setting Facility Modifier None Typical Low $269.15 Median $363.08 Typical High $1,548.82 | Facility | None | $269.15 | $363.08 | $1,548.82 |
United Setting Professional Modifier None Typical Low $169.82 Median $234.42 Typical High $416.87 | Professional | None | $169.82 | $234.42 | $416.87 |
8 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 $117.49 Median $120.23 Typical High $138.04 | Professional | 52 · Reduced service | $117.49 | $120.23 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $47.86 Typical High $54.95 | Professional | 53 · Discontinued | $46.77 | $47.86 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $181.97 Typical High $208.93 | Professional | 54 · Surgery only | $173.78 | $181.97 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $36.31 Typical High $41.69 | Professional | 55 · Aftercare only | $34.67 | $36.31 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $23.99 Typical High $27.54 | Professional | 56 · Pre-op care only | $23.44 | $23.99 | $27.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $162.18 Median $169.82 Typical High $194.98 | Professional | 78 · Unplanned return to OR | $162.18 | $169.82 | $194.98 |
Ambetter Setting Professional Modifier 51 · Multiple procedures Typical Low $134.90 Median $134.90 Typical High $134.90 | Professional | 51 · Multiple procedures | $134.90 | $134.90 | $134.90 |
Qualchoice Setting Professional Modifier 51 · Multiple procedures Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | 51 · Multiple procedures | $154.88 | $154.88 | $154.88 |
Where Arkansas sits
The same service costs 4.3 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· 27th of 51
$288
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.