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 $3,715.35 Median $3,715.35 Typical High $3,981.07 | Facility | None | $3,715.35 | $3,715.35 | $3,981.07 |
Aetna Setting Professional Modifier None Typical Low $81.28 Median $114.82 Typical High $120.23 | Professional | None | $81.28 | $114.82 | $120.23 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $58.88 Median $95.50 Typical High $151.36 | Professional | None | $58.88 | $95.50 | $151.36 |
Cigna Setting Facility Modifier None Typical Low $61.66 Median $83.18 Typical High $794.33 | Facility | None | $61.66 | $83.18 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $95.50 Median $125.89 Typical High $162.18 | Professional | None | $95.50 | $125.89 | $162.18 |
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 $66.07 Median $93.33 Typical High $134.90 | Professional | None | $66.07 | $93.33 | $134.90 |
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 $40.74 Median $41.69 Typical High $60.26 | Professional | 52 · Reduced service | $40.74 | $41.69 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $16.98 Typical High $23.99 | Professional | 53 · Discontinued | $16.60 | $16.98 | $23.99 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $61.66 Median $63.10 Typical High $91.20 | Professional | 54 · Surgery only | $61.66 | $63.10 | $91.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $12.59 Typical High $18.20 | Professional | 55 · Aftercare only | $12.30 | $12.59 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $8.51 Typical High $12.02 | Professional | 56 · Pre-op care only | $8.13 | $8.51 | $12.02 |
Where Rhode Island sits
The same service costs 3.1 times more in Wisconsin than in Washington, DC. 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· 23rd of 51
$105
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.