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 $85.11 Median $89.13 Typical High $120.23 | Professional | None | $85.11 | $89.13 | $120.23 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $72.44 Median $104.71 Typical High $147.91 | Professional | None | $72.44 | $104.71 | $147.91 |
Cigna Setting Facility Modifier None Typical Low $95.50 Median $125.89 Typical High $1,202.26 | Facility | None | $95.50 | $125.89 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $141.25 Typical High $173.78 | Professional | None | $123.03 | $141.25 | $173.78 |
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 $60.26 Median $89.13 Typical High $162.18 | Professional | None | $60.26 | $89.13 | $162.18 |
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 $42.66 Median $44.67 Typical High $60.26 | Professional | 52 · Reduced service | $42.66 | $44.67 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $17.78 Typical High $23.99 | Professional | 53 · Discontinued | $17.38 | $17.78 | $23.99 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $64.57 Median $67.61 Typical High $89.13 | Professional | 54 · Surgery only | $64.57 | $67.61 | $89.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $13.49 Typical High $17.78 | Professional | 55 · Aftercare only | $12.88 | $13.49 | $17.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $8.91 Typical High $12.02 | Professional | 56 · Pre-op care only | $8.51 | $8.91 | $12.02 |
Where Rhode Island sits
The same service costs 3.8 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· 14th of 51
$120
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.