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 $37.15 Median $58.88 Typical High $85.11 | Professional | None | $37.15 | $58.88 | $85.11 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $26.30 Median $46.77 Typical High $91.20 | Professional | None | $26.30 | $46.77 | $91.20 |
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 $39.81 Median $58.88 Typical High $95.50 | Professional | None | $39.81 | $58.88 | $95.50 |
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 $31.62 Median $46.77 Typical High $93.33 | Professional | None | $31.62 | $46.77 | $93.33 |
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 $18.62 Median $22.91 Typical High $40.74 | Professional | 52 · Reduced service | $18.62 | $22.91 | $40.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.59 Median $9.12 Typical High $16.22 | Professional | 53 · Discontinued | $7.59 | $9.12 | $16.22 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $28.18 Median $34.67 Typical High $60.26 | Professional | 54 · Surgery only | $28.18 | $34.67 | $60.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.62 Median $6.92 Typical High $12.02 | Professional | 55 · Aftercare only | $5.62 | $6.92 | $12.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.72 Median $4.57 Typical High $8.13 | Professional | 56 · Pre-op care only | $3.72 | $4.57 | $8.13 |
Where Rhode Island sits
The same service costs 3.4 times more in Wisconsin than in Utah. 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· 27th of 51
$54.95
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.