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 $39.81 Median $95.50 Typical High $134.90 | Professional | None | $39.81 | $95.50 | $134.90 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $34.67 Median $75.86 Typical High $208.93 | Professional | None | $34.67 | $75.86 | $208.93 |
Cigna Setting Facility Modifier None Typical Low $107.15 Median $144.54 Typical High $1,202.26 | Facility | None | $107.15 | $144.54 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $46.77 Median $77.62 Typical High $213.80 | Professional | None | $46.77 | $77.62 | $213.80 |
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 $32.36 Median $67.61 Typical High $154.88 | Professional | None | $32.36 | $67.61 | $154.88 |
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 $19.95 Median $25.12 Typical High $67.61 | Professional | 52 · Reduced service | $19.95 | $25.12 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.94 Median $10.00 Typical High $26.92 | Professional | 53 · Discontinued | $7.94 | $10.00 | $26.92 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $30.20 Median $37.15 Typical High $102.33 | Professional | 54 · Surgery only | $30.20 | $37.15 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.03 Median $7.59 Typical High $20.42 | Professional | 55 · Aftercare only | $6.03 | $7.59 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.98 Median $5.01 Typical High $13.49 | Professional | 56 · Pre-op care only | $3.98 | $5.01 | $13.49 |
Where Rhode Island sits
The same service costs 5.4 times more in Wisconsin than in Hawaii. 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· 37th of 51
$95.50
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.