How much rates vary
Facilitymedian $1,230 · 10th to 90th $794 to $2,512Professionalmedian $427 · 10th to 90th $219 to $661
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 $281.84 Median $977.24 Typical High $2,041.74 | Facility | None | $281.84 | $977.24 | $2,041.74 |
Aetna Setting Professional Modifier None Typical Low $234.42 Median $389.05 Typical High $512.86 | Professional | None | $234.42 | $389.05 | $512.86 |
Ambetter Setting Professional Modifier None Typical Low $257.04 Median $363.08 Typical High $660.69 | Professional | None | $257.04 | $363.08 | $660.69 |
BCBS Arkansas Setting Facility Modifier None Typical Low $912.01 Median $1,819.70 Typical High $2,511.89 | Facility | None | $912.01 | $1,819.70 | $2,511.89 |
BCBS Arkansas Setting Professional Modifier None Typical Low $218.78 Median $288.40 Typical High $645.65 | Professional | None | $218.78 | $288.40 | $645.65 |
CareSource Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $489.78 | Professional | None | $489.78 | $489.78 | $489.78 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $891.25 Typical High $1,071.52 | Facility | None | $562.34 | $891.25 | $1,071.52 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $489.78 Typical High $891.25 | Professional | None | $288.40 | $489.78 | $891.25 |
Qualchoice Setting Professional Modifier None Typical Low $295.12 Median $426.58 Typical High $758.58 | Professional | None | $295.12 | $426.58 | $758.58 |
United Setting Facility Modifier None Typical Low $794.33 Median $1,148.15 Typical High $3,162.28 | Facility | None | $794.33 | $1,148.15 | $3,162.28 |
United Setting Professional Modifier None Typical Low $208.93 Median $389.05 Typical High $758.58 | Professional | None | $208.93 | $389.05 | $758.58 |
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 $138.04 Median $177.83 Typical High $251.19 | Professional | 52 · Reduced service | $138.04 | $177.83 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $70.79 Typical High $100.00 | Professional | 53 · Discontinued | $56.23 | $70.79 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $263.03 Typical High $371.54 | Professional | 54 · Surgery only | $208.93 | $263.03 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $52.48 Typical High $74.13 | Professional | 55 · Aftercare only | $41.69 | $52.48 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $35.48 Typical High $50.12 | Professional | 56 · Pre-op care only | $28.18 | $35.48 | $50.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $245.47 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $194.98 | $245.47 | $346.74 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $389.05 Median $562.34 Typical High $977.24 | Professional | 50 · Both sides | $389.05 | $562.34 | $977.24 |
Qualchoice Setting Professional Modifier 50 · Both sides Typical Low $446.68 Median $616.60 Typical High $1,122.02 | Professional | 50 · Both sides | $446.68 | $616.60 | $1,122.02 |
Where Arkansas sits
The same service costs 4.6 times more in Colorado than in Montana. 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 $4,728MT $1,029
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.