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 $72.44 Median $117.49 Typical High $151.36 | Professional | None | $72.44 | $117.49 | $151.36 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $67.61 Median $131.83 Typical High $245.47 | Professional | None | $67.61 | $131.83 | $245.47 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $977.24 Typical High $1,380.38 | Facility | None | $446.68 | $977.24 | $1,380.38 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $158.49 Typical High $257.04 | Professional | None | $112.20 | $158.49 | $257.04 |
United Setting Facility Modifier None Typical Low $645.65 Median $1,445.44 Typical High $5,011.87 | Facility | None | $645.65 | $1,445.44 | $5,011.87 |
United Setting Professional Modifier None Typical Low $67.61 Median $120.23 Typical High $234.42 | Professional | None | $67.61 | $120.23 | $234.42 |
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 $36.31 Median $44.67 Typical High $75.86 | Professional | 52 · Reduced service | $36.31 | $44.67 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $17.78 Typical High $30.20 | Professional | 53 · Discontinued | $14.45 | $17.78 | $30.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $53.70 Median $66.07 Typical High $114.82 | Professional | 54 · Surgery only | $53.70 | $66.07 | $114.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $13.18 Typical High $22.91 | Professional | 55 · Aftercare only | $10.96 | $13.18 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $8.91 Typical High $15.14 | Professional | 56 · Pre-op care only | $7.24 | $8.91 | $15.14 |
Where Rhode Island sits
The same service costs 4.9 times more in Alaska than in Hawaii. 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· 41st of 51
$141
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.