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 $97.72 Median $114.82 Typical High $169.82 | Professional | None | $97.72 | $114.82 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $72.44 Median $74.13 Typical High $87.10 | Professional | 54 · Surgery only | $72.44 | $74.13 | $87.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $14.79 Typical High $17.38 | Professional | 55 · Aftercare only | $14.45 | $14.79 | $17.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $10.00 Typical High $11.48 | Professional | 56 · Pre-op care only | $9.77 | $10.00 | $11.48 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $95.50 Median $114.82 Typical High $169.82 | Professional | None | $95.50 | $114.82 | $169.82 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $63.10 Median $81.28 Typical High $131.83 | Professional | 54 · Surgery only | $63.10 | $81.28 | $131.83 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $10.00 Typical High $16.60 | Professional | 55 · Aftercare only | $7.94 | $10.00 | $16.60 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $10.00 Typical High $16.60 | Professional | 56 · Pre-op care only | $7.94 | $10.00 | $16.60 |
Cigna Setting Facility Modifier None Typical Low $102.33 Median $134.90 Typical High $1,202.26 | Facility | None | $102.33 | $134.90 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $162.18 Typical High $257.04 | Professional | None | $125.89 | $162.18 | $257.04 |
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 $83.18 Median $123.03 Typical High $213.80 | Professional | None | $83.18 | $123.03 | $213.80 |
3 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 $48.98 Median $50.12 Typical High $57.54 | Professional | 52 · Reduced service | $48.98 | $50.12 | $57.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $19.95 Typical High $22.91 | Professional | 53 · Discontinued | $19.50 | $19.95 | $22.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $67.61 Median $69.18 Typical High $81.28 | Professional | 78 · Unplanned return to OR | $67.61 | $69.18 | $81.28 |
Where Rhode Island sits
The same service costs 4.4 times more in Alaska 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· 34th of 51
$126
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.