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 $63.10 Median $97.72 Typical High $173.78 | Professional | None | $63.10 | $97.72 | $173.78 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $56.23 Median $114.82 Typical High $186.21 | Professional | None | $56.23 | $114.82 | $186.21 |
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 $93.33 Median $131.83 Typical High $302.00 | Professional | None | $93.33 | $131.83 | $302.00 |
United Setting Facility Modifier None Typical Low $97.72 Median $295.12 Typical High $3,890.45 | Facility | None | $97.72 | $295.12 | $3,890.45 |
United Setting Professional Modifier None Typical Low $64.57 Median $107.15 Typical High $213.80 | Professional | None | $64.57 | $107.15 | $213.80 |
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 $30.90 Median $37.15 Typical High $52.48 | Professional | 52 · Reduced service | $30.90 | $37.15 | $52.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.59 Median $15.14 Typical High $20.89 | Professional | 53 · Discontinued | $12.59 | $15.14 | $20.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $46.77 Median $56.23 Typical High $79.43 | Professional | 54 · Surgery only | $46.77 | $56.23 | $79.43 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $11.22 Typical High $15.85 | Professional | 55 · Aftercare only | $9.33 | $11.22 | $15.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $7.59 Typical High $10.47 | Professional | 56 · Pre-op care only | $6.31 | $7.59 | $10.47 |
Where Rhode Island sits
The same service costs 4.0 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· 43rd 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.