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 $64.57 Median $75.86 Typical High $95.50 | Professional | None | $64.57 | $75.86 | $95.50 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $51.29 Median $77.62 Typical High $114.82 | Professional | None | $51.29 | $77.62 | $114.82 |
Cigna Setting Facility Modifier None Typical Low $74.13 Median $97.72 Typical High $1,202.26 | Facility | None | $74.13 | $97.72 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $104.71 Typical High $134.90 | Professional | None | $87.10 | $104.71 | $134.90 |
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 $44.67 Median $67.61 Typical High $125.89 | Professional | None | $44.67 | $67.61 | $125.89 |
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 $32.36 Median $37.15 Typical High $47.86 | Professional | 52 · Reduced service | $32.36 | $37.15 | $47.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $14.79 Typical High $19.05 | Professional | 53 · Discontinued | $12.88 | $14.79 | $19.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $48.98 Median $56.23 Typical High $70.79 | Professional | 54 · Surgery only | $48.98 | $56.23 | $70.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $11.22 Typical High $14.45 | Professional | 55 · Aftercare only | $9.77 | $11.22 | $14.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $7.41 Typical High $9.55 | Professional | 56 · Pre-op care only | $6.46 | $7.41 | $9.55 |
Where Rhode Island sits
The same service costs 3.6 times more in Alaska than in Kentucky. 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· 22nd of 51
$87.10
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.