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 $524.81 Median $831.76 Typical High $2,511.89 | Professional | None | $524.81 | $831.76 | $2,511.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $512.86 Typical High $1,905.46 | Professional | 54 · Surgery only | $389.05 | $512.86 | $1,905.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $102.33 Typical High $380.19 | Professional | 55 · Aftercare only | $77.62 | $102.33 | $380.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $67.61 Typical High $251.19 | Professional | 56 · Pre-op care only | $52.48 | $67.61 | $251.19 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $407.38 Median $1,348.96 Typical High $2,818.38 | Professional | None | $407.38 | $1,348.96 | $2,818.38 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $1,000.00 Typical High $1,659.59 | Professional | 54 · Surgery only | $275.42 | $1,000.00 | $1,659.59 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $107.15 Typical High $181.97 | Professional | 55 · Aftercare only | $30.20 | $107.15 | $181.97 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $95.50 Typical High $162.18 | Professional | 56 · Pre-op care only | $26.92 | $95.50 | $162.18 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $2,398.83 Typical High $3,235.94 | Facility | None | $676.08 | $2,398.83 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $575.44 Median $891.25 Typical High $3,311.31 | Professional | None | $575.44 | $891.25 | $3,311.31 |
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 $467.74 Median $1,348.96 Typical High $2,818.38 | Professional | None | $467.74 | $1,348.96 | $2,818.38 |
2 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 $257.04 Median $338.84 Typical High $1,258.93 | Professional | 52 · Reduced service | $257.04 | $338.84 | $1,258.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $134.90 Typical High $501.19 | Professional | 53 · Discontinued | $104.71 | $134.90 | $501.19 |
Where Rhode Island sits
The same service costs 3.6 times more in Iowa 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· 40th of 51
$1,514
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.