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 $162.18 Median $208.93 Typical High $208.93 | Professional | None | $162.18 | $208.93 | $208.93 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $138.04 Median $186.21 Typical High $257.04 | Professional | None | $138.04 | $186.21 | $257.04 |
Cigna Setting Facility Modifier None Typical Low $125.89 Median $169.82 Typical High $1,202.26 | Facility | None | $125.89 | $169.82 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $269.15 Typical High $316.23 | Professional | None | $229.09 | $269.15 | $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 $117.49 Median $181.97 Typical High $316.23 | Professional | None | $117.49 | $181.97 | $316.23 |
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 $81.28 Median $104.71 Typical High $104.71 | Professional | 52 · Reduced service | $81.28 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $41.69 Typical High $41.69 | Professional | 53 · Discontinued | $32.36 | $41.69 | $41.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $158.49 Typical High $158.49 | Professional | 54 · Surgery only | $120.23 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $31.62 Typical High $31.62 | Professional | 55 · Aftercare only | $23.99 | $31.62 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $20.89 Typical High $20.89 | Professional | 56 · Pre-op care only | $16.22 | $20.89 | $20.89 |
Where Rhode Island sits
The same service costs 3.6 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· 26th 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.