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 $28.84 Median $40.74 Typical High $47.86 | Professional | None | $28.84 | $40.74 | $47.86 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $25.70 Median $33.88 Typical High $57.54 | Professional | None | $25.70 | $33.88 | $57.54 |
Cigna Setting Facility Modifier None Typical Low $19.50 Median $26.30 Typical High $1,071.52 | Facility | None | $19.50 | $26.30 | $1,071.52 |
Cigna Setting Professional Modifier None Typical Low $42.66 Median $52.48 Typical High $57.54 | Professional | None | $42.66 | $52.48 | $57.54 |
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 $21.88 Median $32.36 Typical High $57.54 | Professional | None | $21.88 | $32.36 | $57.54 |
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 $14.45 Median $20.42 Typical High $23.99 | Professional | 52 · Reduced service | $14.45 | $20.42 | $23.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.75 Median $8.13 Typical High $9.77 | Professional | 53 · Discontinued | $5.75 | $8.13 | $9.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $21.88 Median $30.20 Typical High $36.31 | Professional | 54 · Surgery only | $21.88 | $30.20 | $36.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.37 Median $6.17 Typical High $7.24 | Professional | 55 · Aftercare only | $4.37 | $6.17 | $7.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.88 Median $4.07 Typical High $4.79 | Professional | 56 · Pre-op care only | $2.88 | $4.07 | $4.79 |
Where Rhode Island sits
The same service costs 3.5 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· 28th of 51
$39.81
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.