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 $91.20 Median $169.82 Typical High $245.47 | Professional | None | $91.20 | $169.82 | $245.47 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $83.18 Median $147.91 Typical High $234.42 | Professional | None | $83.18 | $147.91 | $234.42 |
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 $144.54 Median $194.98 Typical High $295.12 | Professional | None | $144.54 | $194.98 | $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 $72.44 Median $138.04 Typical High $288.40 | Professional | None | $72.44 | $138.04 | $288.40 |
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 $45.71 Median $61.66 Typical High $123.03 | Professional | 52 · Reduced service | $45.71 | $61.66 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $24.55 Typical High $48.98 | Professional | 53 · Discontinued | $18.62 | $24.55 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $69.18 Median $93.33 Typical High $186.21 | Professional | 54 · Surgery only | $69.18 | $93.33 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $18.62 Typical High $37.15 | Professional | 55 · Aftercare only | $13.80 | $18.62 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $12.30 Typical High $24.55 | Professional | 56 · Pre-op care only | $9.12 | $12.30 | $24.55 |
Where Rhode Island sits
The same service costs 3.9 times more in Alaska than in Virginia. 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· 37th of 51
$148
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.