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 $66.07 Median $100.00 Typical High $141.25 | Professional | None | $66.07 | $100.00 | $141.25 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $54.95 Median $107.15 Typical High $162.18 | Professional | None | $54.95 | $107.15 | $162.18 |
Cigna Setting Facility Modifier None Typical Low $112.20 Median $147.91 Typical High $1,202.26 | Facility | None | $112.20 | $147.91 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $57.54 Median $131.83 Typical High $288.40 | Professional | None | $57.54 | $131.83 | $288.40 |
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 $56.23 Median $100.00 Typical High $223.87 | Professional | None | $56.23 | $100.00 | $223.87 |
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 $41.69 Typical High $56.23 | Professional | 52 · Reduced service | $33.11 | $41.69 | $56.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $16.60 Typical High $22.39 | Professional | 53 · Discontinued | $13.49 | $16.60 | $22.39 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $50.12 Median $61.66 Typical High $83.18 | Professional | 54 · Surgery only | $50.12 | $61.66 | $83.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $12.30 Typical High $16.98 | Professional | 55 · Aftercare only | $10.00 | $12.30 | $16.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $8.32 Typical High $11.22 | Professional | 56 · Pre-op care only | $6.61 | $8.32 | $11.22 |
Where Rhode Island sits
The same service costs 3.2 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· 31st of 51
$112
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.