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 $151.36 Median $169.82 Typical High $316.23 | Professional | None | $151.36 | $169.82 | $316.23 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $83.18 Median $169.82 Typical High $331.13 | Professional | None | $83.18 | $169.82 | $331.13 |
Cigna Setting Facility Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $1,445.44 | Facility | None | $1,445.44 | $1,445.44 | $1,445.44 |
Cigna Setting Professional Modifier None Typical Low $74.13 Median $151.36 Typical High $512.86 | Professional | None | $74.13 | $151.36 | $512.86 |
United Setting Facility Modifier None Typical Low $891.25 Median $891.25 Typical High $891.25 | Facility | None | $891.25 | $891.25 | $891.25 |
United Setting Professional Modifier None Typical Low $107.15 Median $208.93 Typical High $426.58 | Professional | None | $107.15 | $208.93 | $426.58 |
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 $75.86 Median $85.11 Typical High $158.49 | Professional | 52 · Reduced service | $75.86 | $85.11 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $33.88 Typical High $63.10 | Professional | 53 · Discontinued | $30.20 | $33.88 | $63.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $125.89 Typical High $239.88 | Professional | 54 · Surgery only | $112.20 | $125.89 | $239.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $25.70 Typical High $47.86 | Professional | 55 · Aftercare only | $22.39 | $25.70 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $16.98 Typical High $31.62 | Professional | 56 · Pre-op care only | $15.14 | $16.98 | $31.62 |
Where Rhode Island sits
The same service costs 3.4 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· 45th of 51
$178
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.