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 $95.50 Median $104.71 Typical High $141.25 | Professional | None | $95.50 | $104.71 | $141.25 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $54.95 Median $79.43 Typical High $141.25 | Professional | None | $54.95 | $79.43 | $141.25 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $67.61 Typical High $794.33 | Facility | None | $50.12 | $67.61 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $89.13 Median $114.82 Typical High $141.25 | Professional | None | $89.13 | $114.82 | $141.25 |
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 $46.77 Median $81.28 Typical High $134.90 | Professional | None | $46.77 | $81.28 | $134.90 |
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 $47.86 Median $50.12 Typical High $67.61 | Professional | 52 · Reduced service | $47.86 | $50.12 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.05 Median $19.95 Typical High $26.92 | Professional | 53 · Discontinued | $19.05 | $19.95 | $26.92 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $70.79 Median $74.13 Typical High $102.33 | Professional | 54 · Surgery only | $70.79 | $74.13 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $14.79 Typical High $20.42 | Professional | 55 · Aftercare only | $14.13 | $14.79 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $10.00 Typical High $13.49 | Professional | 56 · Pre-op care only | $9.55 | $10.00 | $13.49 |
Where Rhode Island sits
The same service costs 3.2 times more in Alaska than in Texas. 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· 21st of 51
$95.50
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.