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 $97.72 Median $114.82 Typical High $158.49 | Professional | None | $97.72 | $114.82 | $158.49 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $74.13 Median $147.91 Typical High $199.53 | Professional | None | $74.13 | $147.91 | $199.53 |
Cigna Setting Facility Modifier None Typical Low $141.25 Median $190.55 Typical High $794.33 | Facility | None | $141.25 | $190.55 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $134.90 Median $165.96 Typical High $316.23 | Professional | None | $134.90 | $165.96 | $316.23 |
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 $77.62 Median $128.82 Typical High $208.93 | Professional | None | $77.62 | $128.82 | $208.93 |
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 $48.98 Median $57.54 Typical High $77.62 | Professional | 52 · Reduced service | $48.98 | $57.54 | $77.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $22.91 Typical High $31.62 | Professional | 53 · Discontinued | $19.95 | $22.91 | $31.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $74.13 Median $87.10 Typical High $117.49 | Professional | 54 · Surgery only | $74.13 | $87.10 | $117.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $17.38 Typical High $23.44 | Professional | 55 · Aftercare only | $14.79 | $17.38 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $11.48 Typical High $15.85 | Professional | 56 · Pre-op care only | $9.77 | $11.48 | $15.85 |
Where Rhode Island sits
The same service costs 3.6 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
$148
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.