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 $125.89 Median $162.18 Typical High $208.93 | Professional | None | $125.89 | $162.18 | $208.93 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $93.33 Median $141.25 Typical High $204.17 | Professional | None | $93.33 | $141.25 | $204.17 |
Cigna Setting Facility Modifier None Typical Low $91.20 Median $123.03 Typical High $794.33 | Facility | None | $91.20 | $123.03 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $190.55 Typical High $257.04 | Professional | None | $138.04 | $190.55 | $257.04 |
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 $97.72 Median $134.90 Typical High $181.97 | Professional | None | $97.72 | $134.90 | $181.97 |
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 $63.10 Median $63.10 Typical High $81.28 | Professional | 52 · Reduced service | $63.10 | $63.10 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $25.12 Typical High $32.36 | Professional | 53 · Discontinued | $25.12 | $25.12 | $32.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $93.33 Typical High $120.23 | Professional | 54 · Surgery only | $93.33 | $93.33 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $18.62 Typical High $23.99 | Professional | 55 · Aftercare only | $18.62 | $18.62 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $12.59 Typical High $16.22 | Professional | 56 · Pre-op care only | $12.59 | $12.59 | $16.22 |
Where Rhode Island sits
The same service costs 3.3 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
$155
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.