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 $144.54 Median $165.96 Typical High $229.09 | Professional | None | $144.54 | $165.96 | $229.09 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $131.83 Median $218.78 Typical High $363.08 | Professional | None | $131.83 | $218.78 | $363.08 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $2,187.76 Typical High $3,162.28 | Facility | None | $588.84 | $2,187.76 | $3,162.28 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $281.84 Typical High $446.68 | Professional | None | $199.53 | $281.84 | $446.68 |
United Setting Facility Modifier None Typical Low $870.96 Median $2,089.30 Typical High $7,413.10 | Facility | None | $870.96 | $2,089.30 | $7,413.10 |
United Setting Professional Modifier None Typical Low $138.04 Median $213.80 Typical High $316.23 | Professional | None | $138.04 | $213.80 | $316.23 |
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 $72.44 Median $83.18 Typical High $114.82 | Professional | 52 · Reduced service | $72.44 | $83.18 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $33.11 Typical High $46.77 | Professional | 53 · Discontinued | $28.84 | $33.11 | $46.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $123.03 Typical High $173.78 | Professional | 54 · Surgery only | $109.65 | $123.03 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $24.55 Typical High $34.67 | Professional | 55 · Aftercare only | $21.88 | $24.55 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $16.60 Typical High $22.91 | Professional | 56 · Pre-op care only | $14.45 | $16.60 | $22.91 |
Where Rhode Island sits
The same service costs 3.7 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· 38th of 51
$229
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.