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 $229.09 Median $245.47 Typical High $288.40 | Professional | None | $229.09 | $245.47 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $181.97 Typical High $218.78 | Professional | 54 · Surgery only | $177.83 | $181.97 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $36.31 Typical High $43.65 | Professional | 55 · Aftercare only | $35.48 | $36.31 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $24.55 Typical High $28.84 | Professional | 56 · Pre-op care only | $23.44 | $24.55 | $28.84 |
BCBS Setting Professional Modifier None Typical Low $204.17 Median $251.19 Typical High $407.38 | Professional | None | $204.17 | $251.19 | $407.38 |
BCBS Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $177.83 Typical High $295.12 | Professional | 54 · Surgery only | $134.90 | $177.83 | $295.12 |
BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $22.39 Typical High $36.31 | Professional | 55 · Aftercare only | $16.60 | $22.39 | $36.31 |
BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $22.39 Typical High $36.31 | Professional | 56 · Pre-op care only | $16.60 | $22.39 | $36.31 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $977.24 Typical High $1,380.38 | Facility | None | $446.68 | $977.24 | $1,380.38 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $269.15 Typical High $602.56 | Professional | None | $213.80 | $269.15 | $602.56 |
United Setting Facility Modifier None Typical Low $371.54 Median $1,096.48 Typical High $4,265.80 | Facility | None | $371.54 | $1,096.48 | $4,265.80 |
United Setting Professional Modifier None Typical Low $190.55 Median $288.40 Typical High $501.19 | Professional | None | $190.55 | $288.40 | $501.19 |
3 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 $117.49 Median $123.03 Typical High $144.54 | Professional | 52 · Reduced service | $117.49 | $123.03 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $48.98 Typical High $57.54 | Professional | 53 · Discontinued | $46.77 | $48.98 | $57.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $169.82 Typical High $204.17 | Professional | 78 · Unplanned return to OR | $165.96 | $169.82 | $204.17 |
Where Rhode Island sits
The same service costs 3.9 times more in Alaska 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.
Rhode Island· 35th of 51
$288
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.