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 $158.49 Median $1,071.52 Typical High $2,041.74 | Facility | None | $158.49 | $1,071.52 | $2,041.74 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $204.17 Typical High $295.12 | Professional | None | $158.49 | $204.17 | $295.12 |
BCBS Arkansas Setting Facility Modifier None Typical Low $524.81 Median $891.25 Typical High $1,202.26 | Facility | None | $524.81 | $891.25 | $1,202.26 |
BCBS Arkansas Setting Professional Modifier None Typical Low $144.54 Median $194.98 Typical High $371.54 | Professional | None | $144.54 | $194.98 | $371.54 |
Cigna Setting Facility Modifier None Typical Low $467.74 Median $512.86 Typical High $758.58 | Facility | None | $467.74 | $512.86 | $758.58 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $257.04 Typical High $389.05 | Professional | None | $162.18 | $257.04 | $389.05 |
United Setting Facility Modifier None Typical Low $407.38 Median $588.84 Typical High $1,995.26 | Facility | None | $407.38 | $588.84 | $1,995.26 |
United Setting Professional Modifier None Typical Low $128.82 Median $245.47 Typical High $478.63 | Professional | None | $128.82 | $245.47 | $478.63 |
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 $79.43 Median $95.50 Typical High $147.91 | Professional | 52 · Reduced service | $79.43 | $95.50 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $38.02 Typical High $58.88 | Professional | 53 · Discontinued | $31.62 | $38.02 | $58.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $144.54 Typical High $223.87 | Professional | 54 · Surgery only | $117.49 | $144.54 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $28.84 Typical High $44.67 | Professional | 55 · Aftercare only | $23.44 | $28.84 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $19.05 Typical High $29.51 | Professional | 56 · Pre-op care only | $15.85 | $19.05 | $29.51 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $109.65 Median $134.90 Typical High $208.93 | Professional | 78 · Unplanned return to OR | $109.65 | $134.90 | $208.93 |
Where Arkansas sits
The same service costs 4.7 times more in Alaska than in Virginia. 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· 20th of 51
$295
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.