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 $2,398.83 Median $3,235.94 Typical High $3,981.07 | Facility | None | $2,398.83 | $3,235.94 | $3,981.07 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $812.83 | Professional | None | $812.83 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $602.56 Typical High $602.56 | Professional | 54 · Surgery only | $602.56 | $602.56 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $123.03 Typical High $123.03 | Professional | 55 · Aftercare only | $123.03 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $81.28 Typical High $81.28 | Professional | 56 · Pre-op care only | $81.28 | $81.28 | $81.28 |
BCBS Setting Professional Modifier None Typical Low $549.54 Median $724.44 Typical High $1,023.29 | Professional | None | $549.54 | $724.44 | $1,023.29 |
BCBS Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $426.58 Typical High $501.19 | Professional | 54 · Surgery only | $354.81 | $426.58 | $501.19 |
BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $128.82 Typical High $151.36 | Professional | 55 · Aftercare only | $107.15 | $128.82 | $151.36 |
BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $61.66 Typical High $72.44 | Professional | 56 · Pre-op care only | $51.29 | $61.66 | $72.44 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $1,258.93 Typical High $1,621.81 | Facility | None | $676.08 | $1,258.93 | $1,621.81 |
Cigna Setting Professional Modifier None Typical Low $1,000.00 Median $1,071.52 Typical High $1,258.93 | Professional | None | $1,000.00 | $1,071.52 | $1,258.93 |
United Setting Facility Modifier None Typical Low $870.96 Median $2,089.30 Typical High $5,888.44 | Facility | None | $870.96 | $2,089.30 | $5,888.44 |
United Setting Professional Modifier None Typical Low $489.78 Median $758.58 Typical High $1,122.02 | Professional | None | $489.78 | $758.58 | $1,122.02 |
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 $407.38 Median $407.38 Typical High $407.38 | Professional | 52 · Reduced service | $407.38 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | 53 · Discontinued | $162.18 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $562.34 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $562.34 | $562.34 | $562.34 |
Where Rhode Island sits
The same service costs 7.4 times more in Alaska than in Texas. 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· 30th of 51
$813
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.