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 $288.40 Median $288.40 Typical High $338.84 | Professional | None | $288.40 | $288.40 | $338.84 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $218.78 Median $269.15 Typical High $426.58 | Professional | None | $218.78 | $269.15 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $199.53 Median $275.42 Typical High $794.33 | Facility | None | $199.53 | $275.42 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $398.11 Typical High $512.86 | Professional | None | $302.00 | $398.11 | $512.86 |
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 $223.87 Median $309.03 Typical High $416.87 | Professional | None | $223.87 | $309.03 | $416.87 |
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 $144.54 Median $144.54 Typical High $165.96 | Professional | 52 · Reduced service | $144.54 | $144.54 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $57.54 Typical High $67.61 | Professional | 53 · Discontinued | $57.54 | $57.54 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $218.78 Typical High $251.19 | Professional | 54 · Surgery only | $218.78 | $218.78 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $43.65 Typical High $50.12 | Professional | 55 · Aftercare only | $43.65 | $43.65 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $28.84 Typical High $33.88 | Professional | 56 · Pre-op care only | $28.84 | $28.84 | $33.88 |
Where Rhode Island sits
The same service costs 3.7 times more in Alaska than in Maryland. 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
$316
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.