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 $204.17 Median $234.42 Typical High $302.00 | Professional | None | $204.17 | $234.42 | $302.00 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $177.83 Median $281.84 Typical High $426.58 | Professional | None | $177.83 | $281.84 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $186.21 Median $245.47 Typical High $1,202.26 | Facility | None | $186.21 | $245.47 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $363.08 Typical High $512.86 | Professional | None | $281.84 | $363.08 | $512.86 |
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 $147.91 Median $234.42 Typical High $457.09 | Professional | None | $147.91 | $234.42 | $457.09 |
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 $102.33 Median $112.20 Typical High $151.36 | Professional | 52 · Reduced service | $102.33 | $112.20 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $44.67 Typical High $61.66 | Professional | 53 · Discontinued | $40.74 | $44.67 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $165.96 Typical High $229.09 | Professional | 54 · Surgery only | $151.36 | $165.96 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $33.11 Typical High $45.71 | Professional | 55 · Aftercare only | $30.20 | $33.11 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $22.39 Typical High $30.20 | Professional | 56 · Pre-op care only | $20.42 | $22.39 | $30.20 |
Where Rhode Island sits
The same service costs 4.0 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· 19th of 51
$302
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.