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 $2,089.30 Median $2,754.23 Typical High $3,981.07 | Facility | None | $2,089.30 | $2,754.23 | $3,981.07 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $245.47 Typical High $295.12 | Professional | None | $151.36 | $245.47 | $295.12 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $134.90 Median $239.88 Typical High $457.09 | Professional | None | $134.90 | $239.88 | $457.09 |
Cigna Setting Facility Modifier None Typical Low $257.04 Median $354.81 Typical High $1,071.52 | Facility | None | $257.04 | $354.81 | $1,071.52 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $316.23 Typical High $467.74 | Professional | None | $213.80 | $316.23 | $467.74 |
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 $144.54 Median $239.88 Typical High $398.11 | Professional | None | $144.54 | $239.88 | $398.11 |
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 $75.86 Median $104.71 Typical High $147.91 | Professional | 52 · Reduced service | $75.86 | $104.71 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $42.66 Typical High $58.88 | Professional | 53 · Discontinued | $30.90 | $42.66 | $58.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $158.49 Typical High $218.78 | Professional | 54 · Surgery only | $114.82 | $158.49 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $31.62 Typical High $43.65 | Professional | 55 · Aftercare only | $22.91 | $31.62 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $21.38 Typical High $29.51 | Professional | 56 · Pre-op care only | $15.14 | $21.38 | $29.51 |
Where Rhode Island sits
The same service costs 3.2 times more in Wisconsin 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· 36th of 51
$269
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.