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 $50.12 Median $74.13 Typical High $89.13 | Professional | None | $50.12 | $74.13 | $89.13 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $41.69 Median $63.10 Typical High $91.20 | Professional | None | $41.69 | $63.10 | $91.20 |
Cigna Setting Facility Modifier None Typical Low $51.29 Median $69.18 Typical High $794.33 | Facility | None | $51.29 | $69.18 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $87.10 Typical High $114.82 | Professional | None | $72.44 | $87.10 | $114.82 |
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 $35.48 Median $57.54 Typical High $102.33 | Professional | None | $35.48 | $57.54 | $102.33 |
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 $26.92 Median $30.90 Typical High $38.02 | Professional | 52 · Reduced service | $26.92 | $30.90 | $38.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $12.30 Typical High $15.14 | Professional | 53 · Discontinued | $10.96 | $12.30 | $15.14 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $40.74 Median $46.77 Typical High $57.54 | Professional | 54 · Surgery only | $40.74 | $46.77 | $57.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $9.33 Typical High $11.48 | Professional | 55 · Aftercare only | $8.13 | $9.33 | $11.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $6.17 Typical High $7.59 | Professional | 56 · Pre-op care only | $5.37 | $6.17 | $7.59 |
Where Rhode Island sits
The same service costs 3.5 times more in Alaska than in Florida. 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· 21st of 51
$72.44
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.