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 $213.80 Median $223.87 Typical High $524.81 | Professional | None | $213.80 | $223.87 | $524.81 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $147.91 Median $302.00 Typical High $676.08 | Professional | None | $147.91 | $302.00 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $1,122.02 Typical High $1,202.26 | Facility | None | $676.08 | $1,122.02 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $309.03 Typical High $691.83 | Professional | None | $218.78 | $309.03 | $691.83 |
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 $194.98 Median $302.00 Typical High $575.44 | Professional | None | $194.98 | $302.00 | $575.44 |
3 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 54 · Surgery only Typical Low $162.18 Median $165.96 Typical High $389.05 | Professional | 54 · Surgery only | $162.18 | $165.96 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $33.11 Typical High $77.62 | Professional | 55 · Aftercare only | $32.36 | $33.11 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $21.88 Typical High $52.48 | Professional | 56 · Pre-op care only | $21.38 | $21.88 | $52.48 |
Where Rhode Island sits
The same service costs 3.4 times more in Alaska than in Nebraska. 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· 37th of 51
$331
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.