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 $74.13 Median $120.23 Typical High $151.36 | Professional | None | $74.13 | $120.23 | $151.36 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $47.86 Median $89.13 Typical High $204.17 | Professional | None | $47.86 | $89.13 | $204.17 |
Cigna Setting Facility Modifier None Typical Low $75.86 Median $102.33 Typical High $1,202.26 | Facility | None | $75.86 | $102.33 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $128.82 Typical High $208.93 | Professional | None | $87.10 | $128.82 | $208.93 |
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 $67.61 Median $104.71 Typical High $169.82 | Professional | None | $67.61 | $104.71 | $169.82 |
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 $37.15 Median $43.65 Typical High $75.86 | Professional | 52 · Reduced service | $37.15 | $43.65 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $17.38 Typical High $30.20 | Professional | 53 · Discontinued | $14.79 | $17.38 | $30.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $54.95 Median $66.07 Typical High $114.82 | Professional | 54 · Surgery only | $54.95 | $66.07 | $114.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $13.18 Typical High $22.91 | Professional | 55 · Aftercare only | $10.96 | $13.18 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $8.71 Typical High $15.14 | Professional | 56 · Pre-op care only | $7.41 | $8.71 | $15.14 |
Where Rhode Island sits
The same service costs 2.8 times more in Alaska than in Pennsylvania. 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
$105
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.