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 $144.54 Median $190.55 Typical High $234.42 | Professional | None | $144.54 | $190.55 | $234.42 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $104.71 Median $158.49 Typical High $239.88 | Professional | None | $104.71 | $158.49 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $95.50 Median $131.83 Typical High $794.33 | Facility | None | $95.50 | $131.83 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $218.78 Typical High $269.15 | Professional | None | $162.18 | $218.78 | $269.15 |
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 $112.20 Median $154.88 Typical High $213.80 | Professional | None | $112.20 | $154.88 | $213.80 |
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 $72.44 Median $72.44 Typical High $95.50 | Professional | 52 · Reduced service | $72.44 | $72.44 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $28.84 Typical High $38.02 | Professional | 53 · Discontinued | $28.84 | $28.84 | $38.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $109.65 Typical High $141.25 | Professional | 54 · Surgery only | $109.65 | $109.65 | $141.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $21.88 Typical High $28.18 | Professional | 55 · Aftercare only | $21.88 | $21.88 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $14.45 Typical High $19.05 | Professional | 56 · Pre-op care only | $14.45 | $14.45 | $19.05 |
Where Rhode Island sits
The same service costs 3.2 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
$174
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.