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 $2,089.30 Median $2,754.23 Typical High $3,981.07 | Facility | None | $2,089.30 | $2,754.23 | $3,981.07 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $302.00 Typical High $371.54 | Professional | None | $190.55 | $302.00 | $371.54 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $169.82 Median $263.03 Typical High $446.68 | Professional | None | $169.82 | $263.03 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $1,096.48 Typical High $1,584.89 | Facility | None | $446.68 | $1,096.48 | $1,584.89 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $354.81 Typical High $524.81 | Professional | None | $275.42 | $354.81 | $524.81 |
United Setting Facility Modifier None Typical Low $645.65 Median $1,445.44 Typical High $5,011.87 | Facility | None | $645.65 | $1,445.44 | $5,011.87 |
United Setting Professional Modifier None Typical Low $186.21 Median $288.40 Typical High $416.87 | Professional | None | $186.21 | $288.40 | $416.87 |
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 $109.65 Median $109.65 Typical High $186.21 | Professional | 52 · Reduced service | $109.65 | $109.65 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $43.65 Typical High $74.13 | Professional | 53 · Discontinued | $43.65 | $43.65 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $165.96 Typical High $275.42 | Professional | 54 · Surgery only | $165.96 | $165.96 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $33.11 Typical High $54.95 | Professional | 55 · Aftercare only | $33.11 | $33.11 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $21.88 Typical High $37.15 | Professional | 56 · Pre-op care only | $21.88 | $21.88 | $37.15 |
Where Rhode Island sits
The same service costs 3.1 times more in Alaska than in New York. 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· 36th of 51
$309
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.