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 $67.61 Median $100.00 Typical High $141.25 | Professional | None | $67.61 | $100.00 | $141.25 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $52.48 Median $102.33 Typical High $134.90 | Professional | None | $52.48 | $102.33 | $134.90 |
Cigna Setting Facility Modifier None Typical Low $269.15 Median $269.15 Typical High $1,202.26 | Facility | None | $269.15 | $269.15 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $117.49 Typical High $199.53 | Professional | None | $87.10 | $117.49 | $199.53 |
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 $60.26 Median $91.20 Typical High $138.04 | Professional | None | $60.26 | $91.20 | $138.04 |
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 $35.48 Median $36.31 Typical High $50.12 | Professional | 52 · Reduced service | $35.48 | $36.31 | $50.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.13 Median $14.45 Typical High $19.95 | Professional | 53 · Discontinued | $14.13 | $14.45 | $19.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $53.70 Median $54.95 Typical High $75.86 | Professional | 54 · Surgery only | $53.70 | $54.95 | $75.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $10.96 Typical High $15.14 | Professional | 55 · Aftercare only | $10.72 | $10.96 | $15.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $7.24 Typical High $10.00 | Professional | 56 · Pre-op care only | $7.08 | $7.24 | $10.00 |
Where Rhode Island sits
The same service costs 3.2 times more in Alaska than in New York. 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· 26th of 51
$100
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.