How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $83.18 Median $104.71 Typical High $218.78 | Professional | None | $83.18 | $104.71 | $218.78 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $51.29 Median $128.82 Typical High $245.47 | Professional | None | $51.29 | $128.82 | $245.47 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $758.58 Typical High $758.58 | Facility | None | $758.58 | $758.58 | $758.58 |
Cigna Setting Professional Modifier None Typical Low $45.71 Median $112.20 Typical High $380.19 | Professional | None | $45.71 | $112.20 | $380.19 |
United Setting Facility Modifier None Typical Low $446.68 Median $446.68 Typical High $446.68 | Facility | None | $446.68 | $446.68 | $446.68 |
United Setting Professional Modifier None Typical Low $66.07 Median $147.91 Typical High $309.03 | Professional | None | $66.07 | $147.91 | $309.03 |
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 $41.69 Median $52.48 Typical High $109.65 | Professional | 52 · Reduced service | $41.69 | $52.48 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $21.38 Typical High $43.65 | Professional | 53 · Discontinued | $16.60 | $21.38 | $43.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $63.10 Median $79.43 Typical High $165.96 | Professional | 54 · Surgery only | $63.10 | $79.43 | $165.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $15.85 Typical High $33.11 | Professional | 55 · Aftercare only | $12.59 | $15.85 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $10.47 Typical High $21.88 | Professional | 56 · Pre-op care only | $8.32 | $10.47 | $21.88 |
Where Rhode Island sits
The same service costs 3.5 times more in Alaska than in Maryland. 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· 44th of 51
$132
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.