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 $91.20 Median $123.03 Typical High $131.83 | Professional | None | $91.20 | $123.03 | $131.83 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $69.18 Median $109.65 Typical High $154.88 | Professional | None | $69.18 | $109.65 | $154.88 |
Cigna Setting Facility Modifier None Typical Low $70.79 Median $95.50 Typical High $794.33 | Facility | None | $70.79 | $95.50 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $138.04 Typical High $204.17 | Professional | None | $107.15 | $138.04 | $204.17 |
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 $70.79 Median $102.33 Typical High $141.25 | Professional | None | $70.79 | $102.33 | $141.25 |
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 $45.71 Median $45.71 Typical High $61.66 | Professional | 52 · Reduced service | $45.71 | $45.71 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $18.20 Typical High $24.55 | Professional | 53 · Discontinued | $18.20 | $18.20 | $24.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $69.18 Median $69.18 Typical High $91.20 | Professional | 54 · Surgery only | $69.18 | $69.18 | $91.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $13.80 Typical High $18.62 | Professional | 55 · Aftercare only | $13.80 | $13.80 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $9.12 Typical High $12.30 | Professional | 56 · Pre-op care only | $9.12 | $9.12 | $12.30 |
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· 22nd of 51
$117
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.