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 $3,715.35 Median $3,715.35 Typical High $3,981.07 | Facility | None | $3,715.35 | $3,715.35 | $3,981.07 |
Aetna Setting Professional Modifier None Typical Low $6,760.83 Median $6,760.83 Typical High $6,760.83 | Professional | None | $6,760.83 | $6,760.83 | $6,760.83 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $2,238.72 Typical High $3,235.94 | Facility | None | $676.08 | $2,238.72 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $5,623.41 Median $7,762.47 Typical High $8,317.64 | Professional | None | $5,623.41 | $7,762.47 | $8,317.64 |
United Setting Facility Modifier None Typical Low $426.58 Median $1,513.56 Typical High $6,606.93 | Facility | None | $426.58 | $1,513.56 | $6,606.93 |
United Setting Professional Modifier None Typical Low $3,548.13 Median $5,495.41 Typical High $7,079.46 | Professional | None | $3,548.13 | $5,495.41 | $7,079.46 |
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 $3,388.44 Median $3,388.44 Typical High $3,388.44 | Professional | 52 · Reduced service | $3,388.44 | $3,388.44 | $3,388.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1,380.38 Median $1,380.38 Typical High $1,380.38 | Professional | 53 · Discontinued | $1,380.38 | $1,380.38 | $1,380.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $5,128.61 Median $5,128.61 Typical High $5,128.61 | Professional | 54 · Surgery only | $5,128.61 | $5,128.61 | $5,128.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1,023.29 Median $1,023.29 Typical High $1,023.29 | Professional | 55 · Aftercare only | $1,023.29 | $1,023.29 | $1,023.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $676.08 Median $676.08 Typical High $676.08 | Professional | 56 · Pre-op care only | $676.08 | $676.08 | $676.08 |
Where Rhode Island sits
The same service costs 4.4 times more in Alaska than in Arkansas. 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· 13th of 51
$5,888
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.