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 $60.26 Median $89.13 Typical High $131.83 | Professional | None | $60.26 | $89.13 | $131.83 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $30.90 Median $77.62 Typical High $144.54 | Professional | None | $30.90 | $77.62 | $144.54 |
Cigna Setting Facility Modifier None Typical Low $67.61 Median $91.20 Typical High $1,202.26 | Facility | None | $67.61 | $91.20 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $57.54 Median $69.18 Typical High $158.49 | Professional | None | $57.54 | $69.18 | $158.49 |
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 $38.90 Median $61.66 Typical High $125.89 | Professional | None | $38.90 | $61.66 | $125.89 |
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 $30.20 Median $32.36 Typical High $58.88 | Professional | 52 · Reduced service | $30.20 | $32.36 | $58.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $12.88 Typical High $23.44 | Professional | 53 · Discontinued | $12.02 | $12.88 | $23.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $45.71 Median $48.98 Typical High $89.13 | Professional | 54 · Surgery only | $45.71 | $48.98 | $89.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $9.77 Typical High $17.78 | Professional | 55 · Aftercare only | $9.12 | $9.77 | $17.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $6.46 Typical High $11.75 | Professional | 56 · Pre-op care only | $6.03 | $6.46 | $11.75 |
Where Rhode Island sits
The same service costs 3.1 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· 34th of 51
$79.43
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.