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 $69.18 Median $104.71 Typical High $165.96 | Professional | None | $69.18 | $104.71 | $165.96 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $52.48 Median $81.28 Typical High $208.93 | Professional | None | $52.48 | $81.28 | $208.93 |
Cigna Setting Facility Modifier None Typical Low $269.15 Median $269.15 Typical High $1,202.26 | Facility | None | $269.15 | $269.15 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $107.15 Typical High $165.96 | Professional | None | $83.18 | $107.15 | $165.96 |
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 $53.70 Median $85.11 Typical High $141.25 | Professional | None | $53.70 | $85.11 | $141.25 |
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 $38.02 Median $40.74 Typical High $83.18 | Professional | 52 · Reduced service | $38.02 | $40.74 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $16.22 Typical High $33.88 | Professional | 53 · Discontinued | $15.14 | $16.22 | $33.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $56.23 Median $61.66 Typical High $125.89 | Professional | 54 · Surgery only | $56.23 | $61.66 | $125.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $12.30 Typical High $25.12 | Professional | 55 · Aftercare only | $11.22 | $12.30 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $8.13 Typical High $16.60 | Professional | 56 · Pre-op care only | $7.59 | $8.13 | $16.60 |
Where Rhode Island sits
The same service costs 3.2 times more in Wisconsin 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· 29th 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.