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 $38.02 Median $72.44 Typical High $104.71 | Professional | None | $38.02 | $72.44 | $104.71 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $31.62 Median $63.10 Typical High $117.49 | Professional | None | $31.62 | $63.10 | $117.49 |
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 $35.48 Median $87.10 Typical High $181.97 | Professional | None | $35.48 | $87.10 | $181.97 |
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 $33.11 Median $66.07 Typical High $141.25 | Professional | None | $33.11 | $66.07 | $141.25 |
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 $19.05 Median $23.44 Typical High $39.81 | Professional | 52 · Reduced service | $19.05 | $23.44 | $39.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.59 Median $9.33 Typical High $15.85 | Professional | 53 · Discontinued | $7.59 | $9.33 | $15.85 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $28.18 Median $35.48 Typical High $60.26 | Professional | 54 · Surgery only | $28.18 | $35.48 | $60.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.62 Median $7.08 Typical High $12.02 | Professional | 55 · Aftercare only | $5.62 | $7.08 | $12.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.80 Median $4.68 Typical High $7.94 | Professional | 56 · Pre-op care only | $3.80 | $4.68 | $7.94 |
Where Rhode Island sits
The same service costs 3.7 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· 34th 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.