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 $2,089.30 Median $2,754.23 Typical High $3,981.07 | Facility | None | $2,089.30 | $2,754.23 | $3,981.07 |
Aetna Setting Professional Modifier None Typical Low $223.87 Median $295.12 Typical High $549.54 | Professional | None | $223.87 | $295.12 | $549.54 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $173.78 Median $338.84 Typical High $630.96 | Professional | None | $173.78 | $338.84 | $630.96 |
Cigna Setting Facility Modifier None Typical Low $371.54 Median $512.86 Typical High $1,071.52 | Facility | None | $371.54 | $512.86 | $1,071.52 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $380.19 Typical High $776.25 | Professional | None | $257.04 | $380.19 | $776.25 |
United Setting Facility Modifier None Typical Low $371.54 Median $1,096.48 Typical High $4,265.80 | Facility | None | $371.54 | $1,096.48 | $4,265.80 |
United Setting Professional Modifier None Typical Low $181.97 Median $295.12 Typical High $676.08 | Professional | None | $181.97 | $295.12 | $676.08 |
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 $112.20 Median $147.91 Typical High $275.42 | Professional | 52 · Reduced service | $112.20 | $147.91 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $60.26 Typical High $109.65 | Professional | 53 · Discontinued | $44.67 | $60.26 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $223.87 Typical High $407.38 | Professional | 54 · Surgery only | $169.82 | $223.87 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $44.67 Typical High $81.28 | Professional | 55 · Aftercare only | $33.88 | $44.67 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $29.51 Typical High $54.95 | Professional | 56 · Pre-op care only | $22.39 | $29.51 | $54.95 |
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· 35th of 51
$380
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.