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 $66.07 Median $91.20 Typical High $134.90 | Professional | None | $66.07 | $91.20 | $134.90 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $47.86 Median $77.62 Typical High $134.90 | Professional | None | $47.86 | $77.62 | $134.90 |
Cigna Setting Facility Modifier None Typical Low $43.65 Median $58.88 Typical High $1,202.26 | Facility | None | $43.65 | $58.88 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $75.86 Median $100.00 Typical High $131.83 | Professional | None | $75.86 | $100.00 | $131.83 |
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 $50.12 Median $74.13 Typical High $120.23 | Professional | None | $50.12 | $74.13 | $120.23 |
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 $33.11 Median $33.88 Typical High $53.70 | Professional | 52 · Reduced service | $33.11 | $33.88 | $53.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.18 Median $13.49 Typical High $21.38 | Professional | 53 · Discontinued | $13.18 | $13.49 | $21.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $50.12 Median $50.12 Typical High $81.28 | Professional | 54 · Surgery only | $50.12 | $50.12 | $81.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $10.23 Typical High $16.22 | Professional | 55 · Aftercare only | $10.00 | $10.23 | $16.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $6.76 Typical High $10.72 | Professional | 56 · Pre-op care only | $6.61 | $6.76 | $10.72 |
Where Rhode Island sits
The same service costs 3.1 times more in Wisconsin than in Washington, DC. 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· 20th of 51
$87.10
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.