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 $31.62 Median $58.88 Typical High $109.65 | Professional | None | $31.62 | $58.88 | $109.65 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $29.51 Median $61.66 Typical High $141.25 | Professional | None | $29.51 | $61.66 | $141.25 |
Cigna Setting Facility Modifier None Typical Low $269.15 Median $269.15 Typical High $1,202.26 | Facility | None | $269.15 | $269.15 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $31.62 Median $79.43 Typical High $213.80 | Professional | None | $31.62 | $79.43 | $213.80 |
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 $28.84 Median $63.10 Typical High $165.96 | Professional | None | $28.84 | $63.10 | $165.96 |
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 $15.85 Median $22.39 Typical High $36.31 | Professional | 52 · Reduced service | $15.85 | $22.39 | $36.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.31 Median $8.91 Typical High $14.45 | Professional | 53 · Discontinued | $6.31 | $8.91 | $14.45 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $23.44 Median $33.11 Typical High $53.70 | Professional | 54 · Surgery only | $23.44 | $33.11 | $53.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.68 Median $6.76 Typical High $10.72 | Professional | 55 · Aftercare only | $4.68 | $6.76 | $10.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.16 Median $4.47 Typical High $7.24 | Professional | 56 · Pre-op care only | $3.16 | $4.47 | $7.24 |
Where Rhode Island sits
The same service costs 3.3 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· 39th of 51
$72.44
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.