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 $128.82 Median $128.82 Typical High $128.82 | Professional | None | $128.82 | $128.82 | $128.82 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $104.71 Median $141.25 Typical High $199.53 | Professional | None | $104.71 | $141.25 | $199.53 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $616.60 Typical High $794.33 | Facility | None | $446.68 | $616.60 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $190.55 Typical High $239.88 | Professional | None | $158.49 | $190.55 | $239.88 |
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 $102.33 Median $125.89 Typical High $199.53 | Professional | None | $102.33 | $125.89 | $199.53 |
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 $64.57 Median $64.57 Typical High $64.57 | Professional | 52 · Reduced service | $64.57 | $64.57 | $64.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $25.70 Typical High $25.70 | Professional | 53 · Discontinued | $25.70 | $25.70 | $25.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $97.72 Typical High $97.72 | Professional | 54 · Surgery only | $97.72 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $19.50 Typical High $19.50 | Professional | 55 · Aftercare only | $19.50 | $19.50 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $12.88 Typical High $12.88 | Professional | 56 · Pre-op care only | $12.88 | $12.88 | $12.88 |
Where Rhode Island sits
The same service costs 4.4 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· 42nd of 51
$148
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.