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 $64.57 Median $100.00 Typical High $173.78 | Professional | None | $64.57 | $100.00 | $173.78 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $52.48 Median $107.15 Typical High $199.53 | Professional | None | $52.48 | $107.15 | $199.53 |
Cigna Setting Facility Modifier None Typical Low $269.15 Median $269.15 Typical High $1,202.26 | Facility | None | $269.15 | $269.15 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $56.23 Median $134.90 Typical High $295.12 | Professional | None | $56.23 | $134.90 | $295.12 |
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 $54.95 Median $102.33 Typical High $229.09 | Professional | None | $54.95 | $102.33 | $229.09 |
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 $33.11 Median $39.81 Typical High $58.88 | Professional | 52 · Reduced service | $33.11 | $39.81 | $58.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $15.85 Typical High $23.44 | Professional | 53 · Discontinued | $13.49 | $15.85 | $23.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $50.12 Median $60.26 Typical High $87.10 | Professional | 54 · Surgery only | $50.12 | $60.26 | $87.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $12.02 Typical High $17.38 | Professional | 55 · Aftercare only | $10.00 | $12.02 | $17.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $7.94 Typical High $11.75 | Professional | 56 · Pre-op care only | $6.61 | $7.94 | $11.75 |
Where Rhode Island sits
The same service costs 3.5 times more in Alaska than in New Jersey. 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· 32nd of 51
$115
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.