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 $77.62 Median $100.00 Typical High $102.33 | Professional | None | $77.62 | $100.00 | $102.33 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $66.07 Median $89.13 Typical High $131.83 | Professional | None | $66.07 | $89.13 | $131.83 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $91.20 Typical High $1,202.26 | Facility | None | $66.07 | $91.20 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $114.82 Median $125.89 Typical High $154.88 | Professional | None | $114.82 | $125.89 | $154.88 |
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 $57.54 Median $85.11 Typical High $144.54 | Professional | None | $57.54 | $85.11 | $144.54 |
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 $38.90 Median $50.12 Typical High $50.12 | Professional | 52 · Reduced service | $38.90 | $50.12 | $50.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $19.95 Typical High $19.95 | Professional | 53 · Discontinued | $15.49 | $19.95 | $19.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $58.88 Median $74.13 Typical High $74.13 | Professional | 54 · Surgery only | $58.88 | $74.13 | $74.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $15.14 Typical High $15.14 | Professional | 55 · Aftercare only | $11.75 | $15.14 | $15.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $10.00 Typical High $10.00 | Professional | 56 · Pre-op care only | $7.76 | $10.00 | $10.00 |
Where Rhode Island sits
The same service costs 3.8 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· 25th of 51
$100
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.