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 $81.28 Median $112.20 Typical High $151.36 | Professional | None | $81.28 | $112.20 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $69.18 Median $69.18 Typical High $114.82 | Professional | 54 · Surgery only | $69.18 | $69.18 | $114.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $14.13 Typical High $22.91 | Professional | 55 · Aftercare only | $13.80 | $14.13 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $9.33 Typical High $15.14 | Professional | 56 · Pre-op care only | $9.33 | $9.33 | $15.14 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $54.95 Median $91.20 Typical High $158.49 | Professional | None | $54.95 | $91.20 | $158.49 |
Cigna Setting Facility Modifier None Typical Low $81.28 Median $112.20 Typical High $794.33 | Facility | None | $81.28 | $112.20 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $91.20 Median $120.23 Typical High $186.21 | Professional | None | $91.20 | $120.23 | $186.21 |
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 $57.54 Median $93.33 Typical High $162.18 | Professional | None | $57.54 | $93.33 | $162.18 |
2 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 $46.77 Median $46.77 Typical High $75.86 | Professional | 52 · Reduced service | $46.77 | $46.77 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $18.62 Typical High $30.90 | Professional | 53 · Discontinued | $18.62 | $18.62 | $30.90 |
Where Rhode Island sits
The same service costs 2.8 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· 30th of 51
$107
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.