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 $77.62 Median $125.89 Typical High $169.82 | Professional | None | $77.62 | $125.89 | $169.82 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $66.07 Median $128.82 Typical High $239.88 | Professional | None | $66.07 | $128.82 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $134.90 Median $186.21 Typical High $1,202.26 | Facility | None | $134.90 | $186.21 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $151.36 Typical High $295.12 | Professional | None | $102.33 | $151.36 | $295.12 |
United Setting Facility Modifier None Typical Low $645.65 Median $1,445.44 Typical High $5,011.87 | Facility | None | $645.65 | $1,445.44 | $5,011.87 |
United Setting Professional Modifier None Typical Low $64.57 Median $109.65 Typical High $213.80 | Professional | None | $64.57 | $109.65 | $213.80 |
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 $38.90 Median $50.12 Typical High $85.11 | Professional | 52 · Reduced service | $38.90 | $50.12 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $20.42 Typical High $33.88 | Professional | 53 · Discontinued | $15.49 | $20.42 | $33.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $57.54 Median $75.86 Typical High $128.82 | Professional | 54 · Surgery only | $57.54 | $75.86 | $128.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $15.14 Typical High $25.70 | Professional | 55 · Aftercare only | $11.48 | $15.14 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $10.00 Typical High $16.98 | Professional | 56 · Pre-op care only | $7.76 | $10.00 | $16.98 |
Where Rhode Island sits
The same service costs 5.9 times more in Oklahoma than in Kentucky. 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· 35th of 51
$138
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.