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 $181.97 Median $1,071.52 Typical High $2,041.74 | Facility | None | $181.97 | $1,071.52 | $2,041.74 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $218.78 Typical High $331.13 | Professional | None | $169.82 | $218.78 | $331.13 |
Ambetter Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $245.47 | Professional | None | $245.47 | $245.47 | $245.47 |
BCBS Arkansas Setting Facility Modifier None Typical Low $234.42 Median $891.25 Typical High $1,202.26 | Facility | None | $234.42 | $891.25 | $1,202.26 |
BCBS Arkansas Setting Professional Modifier None Typical Low $165.96 Median $218.78 Typical High $389.05 | Professional | None | $165.96 | $218.78 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $186.21 Median $223.87 Typical High $512.86 | Facility | None | $186.21 | $223.87 | $512.86 |
Cigna Setting Professional Modifier None Typical Low $186.21 Median $281.84 Typical High $380.19 | Professional | None | $186.21 | $281.84 | $380.19 |
Qualchoice Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $281.84 | Professional | None | $281.84 | $281.84 | $281.84 |
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 $147.91 Median $257.04 Typical High $446.68 | Professional | None | $147.91 | $257.04 | $446.68 |
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 $89.13 Median $107.15 Typical High $154.88 | Professional | 52 · Reduced service | $89.13 | $107.15 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $42.66 Typical High $61.66 | Professional | 53 · Discontinued | $36.31 | $42.66 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $158.49 Typical High $229.09 | Professional | 54 · Surgery only | $134.90 | $158.49 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $32.36 Typical High $45.71 | Professional | 55 · Aftercare only | $26.92 | $32.36 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $21.38 Typical High $30.90 | Professional | 56 · Pre-op care only | $18.20 | $21.38 | $30.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $125.89 Median $147.91 Typical High $213.80 | Professional | 78 · Unplanned return to OR | $125.89 | $147.91 | $213.80 |
Where Arkansas sits
The same service costs 3.8 times more in Wyoming 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· 25th 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.