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 $389.05 Median $426.58 Typical High $426.58 | Professional | None | $389.05 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $302.00 Typical High $323.59 | Professional | 54 · Surgery only | $288.40 | $302.00 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $60.26 Typical High $64.57 | Professional | 55 · Aftercare only | $58.88 | $60.26 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $39.81 Typical High $42.66 | Professional | 56 · Pre-op care only | $38.90 | $39.81 | $42.66 |
BCBS Setting Professional Modifier None Typical Low $269.15 Median $338.84 Typical High $562.34 | Professional | None | $269.15 | $338.84 | $562.34 |
BCBS Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $199.53 Typical High $263.03 | Professional | 54 · Surgery only | $165.96 | $199.53 | $263.03 |
BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $60.26 Typical High $81.28 | Professional | 55 · Aftercare only | $50.12 | $60.26 | $81.28 |
BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $28.84 Typical High $38.02 | Professional | 56 · Pre-op care only | $23.99 | $28.84 | $38.02 |
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 $467.74 Median $524.81 Typical High $588.84 | Professional | None | $467.74 | $524.81 | $588.84 |
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 $239.88 Median $346.74 Typical High $562.34 | Professional | None | $239.88 | $346.74 | $562.34 |
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 $194.98 Median $199.53 Typical High $213.80 | Professional | 52 · Reduced service | $194.98 | $199.53 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $79.43 Typical High $85.11 | Professional | 53 · Discontinued | $77.62 | $79.43 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $269.15 Median $281.84 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $269.15 | $281.84 | $302.00 |
Where Rhode Island sits
The same service costs 6.8 times more in Alaska than in Utah. 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· 25th of 51
$407
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.