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 $128.82 Median $151.36 Typical High $190.55 | Professional | None | $128.82 | $151.36 | $190.55 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $95.50 Median $134.90 Typical High $190.55 | Professional | None | $95.50 | $134.90 | $190.55 |
Cigna Setting Facility Modifier None Typical Low $83.18 Median $112.20 Typical High $794.33 | Facility | None | $83.18 | $112.20 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $181.97 Typical High $257.04 | Professional | None | $138.04 | $181.97 | $257.04 |
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 $97.72 Median $131.83 Typical High $181.97 | Professional | None | $97.72 | $131.83 | $181.97 |
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 $63.10 Median $63.10 Typical High $75.86 | Professional | 52 · Reduced service | $63.10 | $63.10 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $25.70 Typical High $30.20 | Professional | 53 · Discontinued | $25.70 | $25.70 | $30.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $95.50 Typical High $114.82 | Professional | 54 · Surgery only | $95.50 | $95.50 | $114.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $19.05 Typical High $22.91 | Professional | 55 · Aftercare only | $19.05 | $19.05 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $12.88 Typical High $15.14 | Professional | 56 · Pre-op care only | $12.88 | $12.88 | $15.14 |
Where Rhode Island sits
The same service costs 3.7 times more in Alaska than in Kentucky. 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· 21st of 51
$151
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.