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 $63.10 Median $91.20 Typical High $141.25 | Professional | None | $63.10 | $91.20 | $141.25 |
BCBS Rhode Island Setting Facility Modifier None Typical Low $173.78 Median $190.55 Typical High $245.47 | Facility | None | $173.78 | $190.55 | $245.47 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $58.88 Median $97.72 Typical High $169.82 | Professional | None | $58.88 | $97.72 | $169.82 |
Cigna Setting Facility Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,202.26 | Facility | None | $1,122.02 | $1,122.02 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $81.28 Median $123.03 Typical High $173.78 | Professional | None | $81.28 | $123.03 | $173.78 |
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 $66.07 Median $95.50 Typical High $213.80 | Professional | None | $66.07 | $95.50 | $213.80 |
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 $31.62 Median $38.02 Typical High $66.07 | Professional | 52 · Reduced service | $31.62 | $38.02 | $66.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $15.14 Typical High $26.30 | Professional | 53 · Discontinued | $12.88 | $15.14 | $26.30 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $47.86 Median $57.54 Typical High $100.00 | Professional | 54 · Surgery only | $47.86 | $57.54 | $100.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $11.48 Typical High $19.95 | Professional | 55 · Aftercare only | $9.55 | $11.48 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $7.59 Typical High $13.18 | Professional | 56 · Pre-op care only | $6.31 | $7.59 | $13.18 |
Where Rhode Island sits
The same service costs 3.7 times more in Wisconsin than in Florida. 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· 19th of 51
$115
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.