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 $79.43 Median $120.23 Typical High $138.04 | Professional | None | $79.43 | $120.23 | $138.04 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $53.70 Median $104.71 Typical High $154.88 | Professional | None | $53.70 | $104.71 | $154.88 |
Cigna Setting Facility Modifier None Typical Low $109.65 Median $147.91 Typical High $794.33 | Facility | None | $109.65 | $147.91 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $144.54 Typical High $199.53 | Professional | None | $85.11 | $144.54 | $199.53 |
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 $43.65 Median $89.13 Typical High $186.21 | Professional | None | $43.65 | $89.13 | $186.21 |
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 $39.81 Median $58.88 Typical High $67.61 | Professional | 52 · Reduced service | $39.81 | $58.88 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $23.44 Typical High $27.54 | Professional | 53 · Discontinued | $15.85 | $23.44 | $27.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $60.26 Median $87.10 Typical High $102.33 | Professional | 54 · Surgery only | $60.26 | $87.10 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $17.78 Typical High $20.42 | Professional | 55 · Aftercare only | $12.02 | $17.78 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $11.75 Typical High $13.80 | Professional | 56 · Pre-op care only | $7.94 | $11.75 | $13.80 |
Where Rhode Island sits
The same service costs 3.4 times more in Alaska 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· 36th 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.