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 $190.55 Median $190.55 Typical High $234.42 | Professional | None | $190.55 | $190.55 | $234.42 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $147.91 Median $190.55 Typical High $302.00 | Professional | None | $147.91 | $190.55 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $109.65 Median $147.91 Typical High $794.33 | Facility | None | $109.65 | $147.91 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $263.03 Typical High $331.13 | Professional | None | $199.53 | $263.03 | $331.13 |
United Setting Facility Modifier None Typical Low $371.54 Median $1,096.48 Typical High $4,265.80 | Facility | None | $371.54 | $1,096.48 | $4,265.80 |
United Setting Professional Modifier None Typical Low $151.36 Median $199.53 Typical High $288.40 | Professional | None | $151.36 | $199.53 | $288.40 |
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 $95.50 Median $95.50 Typical High $117.49 | Professional | 52 · Reduced service | $95.50 | $95.50 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $38.02 Typical High $46.77 | Professional | 53 · Discontinued | $38.02 | $38.02 | $46.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $141.25 Typical High $173.78 | Professional | 54 · Surgery only | $141.25 | $141.25 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $28.18 Typical High $34.67 | Professional | 55 · Aftercare only | $28.18 | $28.18 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $19.05 Typical High $23.44 | Professional | 56 · Pre-op care only | $19.05 | $19.05 | $23.44 |
Where Rhode Island sits
The same service costs 3.4 times more in Alaska than in Pennsylvania. 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· 32nd of 51
$224
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.