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 $169.82 Median $218.78 Typical High $245.47 | Professional | None | $169.82 | $218.78 | $245.47 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $128.82 Median $186.21 Typical High $275.42 | Professional | None | $128.82 | $186.21 | $275.42 |
Cigna Setting Facility Modifier None Typical Low $117.49 Median $158.49 Typical High $794.33 | Facility | None | $117.49 | $158.49 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $194.98 Median $257.04 Typical High $316.23 | Professional | None | $194.98 | $257.04 | $316.23 |
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 $131.83 Median $186.21 Typical High $245.47 | Professional | None | $131.83 | $186.21 | $245.47 |
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 $85.11 Median $85.11 Typical High $109.65 | Professional | 52 · Reduced service | $85.11 | $85.11 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $33.88 Typical High $43.65 | Professional | 53 · Discontinued | $33.88 | $33.88 | $43.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $128.82 Typical High $162.18 | Professional | 54 · Surgery only | $128.82 | $128.82 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $25.70 Typical High $32.36 | Professional | 55 · Aftercare only | $25.70 | $25.70 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $16.98 Typical High $21.88 | Professional | 56 · Pre-op care only | $16.98 | $16.98 | $21.88 |
Where Rhode Island sits
The same service costs 3.7 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· 25th of 51
$209
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.