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 $104.71 Median $158.49 Typical High $229.09 | Professional | None | $104.71 | $158.49 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $77.62 Median $97.72 Typical High $134.90 | Professional | 54 · Surgery only | $77.62 | $97.72 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $19.50 Typical High $26.92 | Professional | 55 · Aftercare only | $15.49 | $19.50 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $12.88 Typical High $17.78 | Professional | 56 · Pre-op care only | $10.47 | $12.88 | $17.78 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $93.33 Median $181.97 Typical High $263.03 | Professional | None | $93.33 | $181.97 | $263.03 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $61.66 Median $123.03 Typical High $208.93 | Professional | 54 · Surgery only | $61.66 | $123.03 | $208.93 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $7.76 Median $15.49 Typical High $25.70 | Professional | 55 · Aftercare only | $7.76 | $15.49 | $25.70 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $15.49 Typical High $25.70 | Professional | 56 · Pre-op care only | $7.76 | $15.49 | $25.70 |
Cigna Setting Facility Modifier None Typical Low $269.15 Median $316.23 Typical High $1,202.26 | Facility | None | $269.15 | $316.23 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $257.04 Typical High $446.68 | Professional | None | $125.89 | $257.04 | $446.68 |
United Setting Facility Modifier None Typical Low $371.54 Median $1,096.48 Typical High $4,265.80 | Facility | None | $371.54 | $1,096.48 | $4,265.80 |
United Setting Professional Modifier None Typical Low $85.11 Median $165.96 Typical High $363.08 | Professional | None | $85.11 | $165.96 | $363.08 |
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 $51.29 Median $64.57 Typical High $89.13 | Professional | 52 · Reduced service | $51.29 | $64.57 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $26.30 Typical High $35.48 | Professional | 53 · Discontinued | $20.89 | $26.30 | $35.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $72.44 Median $91.20 Typical High $125.89 | Professional | 78 · Unplanned return to OR | $72.44 | $91.20 | $125.89 |
Where Rhode Island sits
The same service costs 4.1 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· 44th of 51
$182
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.