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 $3,715.35 Median $3,715.35 Typical High $3,981.07 | Facility | None | $3,715.35 | $3,715.35 | $3,981.07 |
Aetna Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $234.42 | Professional | None | $234.42 | $234.42 | $234.42 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $186.21 Median $251.19 Typical High $371.54 | Professional | None | $186.21 | $251.19 | $371.54 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $1,122.02 Typical High $1,202.26 | Facility | None | $676.08 | $1,122.02 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $346.74 Typical High $398.11 | Professional | None | $316.23 | $346.74 | $398.11 |
United Setting Facility Modifier None Typical Low $426.58 Median $1,513.56 Typical High $6,456.54 | Facility | None | $426.58 | $1,513.56 | $6,456.54 |
United Setting Professional Modifier None Typical Low $169.82 Median $234.42 Typical High $389.05 | Professional | None | $169.82 | $234.42 | $389.05 |
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 $117.49 Median $117.49 Typical High $117.49 | Professional | 52 · Reduced service | $117.49 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $46.77 Typical High $46.77 | Professional | 53 · Discontinued | $46.77 | $46.77 | $46.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $177.83 Typical High $177.83 | Professional | 54 · Surgery only | $177.83 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $35.48 Typical High $35.48 | Professional | 55 · Aftercare only | $35.48 | $35.48 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $23.44 Typical High $23.44 | Professional | 56 · Pre-op care only | $23.44 | $23.44 | $23.44 |
Where Rhode Island sits
The same service costs 5.1 times more in Alaska than in Utah. 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· 32nd of 51
$251
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.