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 $134.90 Median $1,071.52 Typical High $2,041.74 | Facility | None | $134.90 | $1,071.52 | $2,041.74 |
Aetna Setting Professional Modifier None Typical Low $134.90 Median $181.97 Typical High $229.09 | Professional | None | $134.90 | $181.97 | $229.09 |
BCBS Arkansas Setting Facility Modifier None Typical Low $181.97 Median $1,412.54 Typical High $1,949.84 | Facility | None | $181.97 | $1,412.54 | $1,949.84 |
BCBS Arkansas Setting Professional Modifier None Typical Low $125.89 Median $165.96 Typical High $269.15 | Professional | None | $125.89 | $165.96 | $269.15 |
Cigna Setting Facility Modifier None Typical Low $151.36 Median $177.83 Typical High $1,000.00 | Facility | None | $151.36 | $177.83 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $181.97 Typical High $346.74 | Professional | None | $112.20 | $181.97 | $346.74 |
United Setting Facility Modifier None Typical Low $407.38 Median $588.84 Typical High $2,187.76 | Facility | None | $407.38 | $588.84 | $2,187.76 |
United Setting Professional Modifier None Typical Low $114.82 Median $186.21 Typical High $338.84 | Professional | None | $114.82 | $186.21 | $338.84 |
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 $67.61 Median $85.11 Typical High $107.15 | Professional | 52 · Reduced service | $67.61 | $85.11 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $33.88 Typical High $43.65 | Professional | 53 · Discontinued | $26.92 | $33.88 | $43.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $100.00 Median $125.89 Typical High $162.18 | Professional | 54 · Surgery only | $100.00 | $125.89 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $25.12 Typical High $32.36 | Professional | 55 · Aftercare only | $19.95 | $25.12 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $16.98 Typical High $21.88 | Professional | 56 · Pre-op care only | $13.49 | $16.98 | $21.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $93.33 Median $117.49 Typical High $151.36 | Professional | 78 · Unplanned return to OR | $93.33 | $117.49 | $151.36 |
Where Arkansas sits
The same service costs 3.9 times more in Oklahoma 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· 37th of 51
$219
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.