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 $204.17 Median $239.88 Typical High $309.03 | Professional | None | $204.17 | $239.88 | $309.03 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $162.18 Median $239.88 Typical High $371.54 | Professional | None | $162.18 | $239.88 | $371.54 |
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 $275.42 Median $331.13 Typical High $436.52 | Professional | None | $275.42 | $331.13 | $436.52 |
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 $134.90 Median $218.78 Typical High $407.38 | Professional | None | $134.90 | $218.78 | $407.38 |
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 $120.23 Typical High $154.88 | Professional | 52 · Reduced service | $102.33 | $120.23 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $47.86 Typical High $61.66 | Professional | 53 · Discontinued | $41.69 | $47.86 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $177.83 Typical High $229.09 | Professional | 54 · Surgery only | $154.88 | $177.83 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $35.48 Typical High $46.77 | Professional | 55 · Aftercare only | $30.90 | $35.48 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $23.99 Typical High $30.90 | Professional | 56 · Pre-op care only | $20.42 | $23.99 | $30.90 |
Where Rhode Island sits
The same service costs 3.9 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· 18th of 51
$275
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.