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 $107.15 Median $141.25 Typical High $338.84 | Professional | None | $107.15 | $141.25 | $338.84 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $97.72 Median $173.78 Typical High $467.74 | Professional | None | $97.72 | $173.78 | $467.74 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $1,122.02 Typical High $1,202.26 | Facility | None | $676.08 | $1,122.02 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $204.17 Typical High $616.60 | Professional | None | $138.04 | $204.17 | $616.60 |
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 $109.65 Median $234.42 Typical High $512.86 | Professional | None | $109.65 | $234.42 | $512.86 |
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 $53.70 Median $70.79 Typical High $169.82 | Professional | 52 · Reduced service | $53.70 | $70.79 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $28.18 Typical High $69.18 | Professional | 53 · Discontinued | $21.38 | $28.18 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $104.71 Typical High $257.04 | Professional | 54 · Surgery only | $81.28 | $104.71 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $20.89 Typical High $51.29 | Professional | 55 · Aftercare only | $16.22 | $20.89 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $14.13 Typical High $33.88 | Professional | 56 · Pre-op care only | $10.72 | $14.13 | $33.88 |
Where Rhode Island sits
The same service costs 3.6 times more in Wisconsin than in Nebraska. 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· 45th of 51
$229
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.