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 $72.44 Median $117.49 Typical High $158.49 | Professional | None | $72.44 | $117.49 | $158.49 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $63.10 Median $117.49 Typical High $218.78 | Professional | None | $63.10 | $117.49 | $218.78 |
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 $66.07 Median $147.91 Typical High $323.59 | Professional | None | $66.07 | $147.91 | $323.59 |
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 $64.57 Median $117.49 Typical High $257.04 | Professional | None | $64.57 | $117.49 | $257.04 |
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 $38.90 Median $46.77 Typical High $69.18 | Professional | 52 · Reduced service | $38.90 | $46.77 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $18.62 Typical High $27.54 | Professional | 53 · Discontinued | $15.85 | $18.62 | $27.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $58.88 Median $70.79 Typical High $102.33 | Professional | 54 · Surgery only | $58.88 | $70.79 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $14.13 Typical High $20.89 | Professional | 55 · Aftercare only | $11.75 | $14.13 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $9.33 Typical High $13.80 | Professional | 56 · Pre-op care only | $7.94 | $9.33 | $13.80 |
Where Rhode Island sits
The same service costs 3.5 times more in Alaska than in Maryland. 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· 35th of 51
$129
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.