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 $1,513.56 Median $1,548.82 Typical High $3,981.07 | Facility | None | $1,513.56 | $1,548.82 | $3,981.07 |
Aetna Setting Professional Modifier None Typical Low $89.13 Median $104.71 Typical High $302.00 | Professional | None | $89.13 | $104.71 | $302.00 |
BCBS Setting Professional Modifier None Typical Low $63.10 Median $173.78 Typical High $416.87 | Professional | None | $63.10 | $173.78 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $1,122.02 Typical High $1,202.26 | Facility | None | $676.08 | $1,122.02 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $208.93 Typical High $575.44 | Professional | None | $128.82 | $208.93 | $575.44 |
United Setting Facility Modifier None Typical Low $97.72 Median $316.23 Typical High $3,890.45 | Facility | None | $97.72 | $316.23 | $3,890.45 |
United Setting Professional Modifier None Typical Low $85.11 Median $199.53 Typical High $426.58 | Professional | None | $85.11 | $199.53 | $426.58 |
5 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 $44.67 Median $51.29 Typical High $151.36 | Professional | 52 · Reduced service | $44.67 | $51.29 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $20.89 Typical High $60.26 | Professional | 53 · Discontinued | $17.78 | $20.89 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $67.61 Median $77.62 Typical High $229.09 | Professional | 54 · Surgery only | $67.61 | $77.62 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $15.49 Typical High $45.71 | Professional | 55 · Aftercare only | $13.49 | $15.49 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $10.47 Typical High $30.20 | Professional | 56 · Pre-op care only | $8.91 | $10.47 | $30.20 |
Where Rhode Island sits
The same service costs 4.5 times more in Oklahoma than in Nebraska. 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.
Rhode Island· 44th of 51
$200
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.