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 $165.96 Median $190.55 Typical High $295.12 | Professional | None | $165.96 | $190.55 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $131.83 Typical High $144.54 | Professional | 54 · Surgery only | $125.89 | $131.83 | $144.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $26.30 Typical High $28.84 | Professional | 55 · Aftercare only | $25.12 | $26.30 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $17.78 Typical High $19.05 | Professional | 56 · Pre-op care only | $16.60 | $17.78 | $19.05 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $165.96 Median $194.98 Typical High $309.03 | Professional | None | $165.96 | $194.98 | $309.03 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $134.90 Typical High $229.09 | Professional | 54 · Surgery only | $107.15 | $134.90 | $229.09 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $16.98 Typical High $28.18 | Professional | 55 · Aftercare only | $13.49 | $16.98 | $28.18 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $16.98 Typical High $28.18 | Professional | 56 · Pre-op care only | $13.49 | $16.98 | $28.18 |
Cigna Setting Facility Modifier None Typical Low $154.88 Median $213.80 Typical High $794.33 | Facility | None | $154.88 | $213.80 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $223.87 Median $269.15 Typical High $446.68 | Professional | None | $223.87 | $269.15 | $446.68 |
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 $151.36 Median $213.80 Typical High $371.54 | Professional | None | $151.36 | $213.80 | $371.54 |
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 $83.18 Median $89.13 Typical High $95.50 | Professional | 52 · Reduced service | $83.18 | $89.13 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $35.48 Typical High $38.02 | Professional | 53 · Discontinued | $33.88 | $35.48 | $38.02 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $117.49 Median $123.03 Typical High $134.90 | Professional | 78 · Unplanned return to OR | $117.49 | $123.03 | $134.90 |
Where Rhode Island sits
The same service costs 4.4 times more in Alaska than in Florida. 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
$224
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.