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 $141.25 Median $190.55 Typical High $190.55 | Professional | None | $141.25 | $190.55 | $190.55 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $120.23 Median $165.96 Typical High $245.47 | Professional | None | $120.23 | $165.96 | $245.47 |
Cigna Setting Facility Modifier None Typical Low $141.25 Median $194.98 Typical High $1,202.26 | Facility | None | $141.25 | $194.98 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $245.47 Typical High $309.03 | Professional | None | $199.53 | $245.47 | $309.03 |
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 $100.00 Median $162.18 Typical High $295.12 | Professional | None | $100.00 | $162.18 | $295.12 |
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 $70.79 Median $95.50 Typical High $95.50 | Professional | 52 · Reduced service | $70.79 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $38.02 Typical High $38.02 | Professional | 53 · Discontinued | $28.18 | $38.02 | $38.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $144.54 Typical High $144.54 | Professional | 54 · Surgery only | $107.15 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $28.84 Typical High $28.84 | Professional | 55 · Aftercare only | $21.38 | $28.84 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $19.05 Typical High $19.05 | Professional | 56 · Pre-op care only | $14.13 | $19.05 | $19.05 |
Where Rhode Island sits
The same service costs 3.3 times more in Alaska than in Virginia. 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· 27th of 51
$191
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.