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 $95.50 Median $134.90 Typical High $208.93 | Professional | None | $95.50 | $134.90 | $208.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $70.79 Median $97.72 Typical High $107.15 | Professional | 54 · Surgery only | $70.79 | $97.72 | $107.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $19.50 Typical High $21.38 | Professional | 55 · Aftercare only | $14.45 | $19.50 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $12.88 Typical High $14.45 | Professional | 56 · Pre-op care only | $9.55 | $12.88 | $14.45 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $95.50 Median $134.90 Typical High $213.80 | Professional | None | $95.50 | $134.90 | $213.80 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $61.66 Median $89.13 Typical High $144.54 | Professional | 54 · Surgery only | $61.66 | $89.13 | $144.54 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $7.76 Median $11.22 Typical High $18.20 | Professional | 55 · Aftercare only | $7.76 | $11.22 | $18.20 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $11.22 Typical High $18.20 | Professional | 56 · Pre-op care only | $7.76 | $11.22 | $18.20 |
Cigna Setting Facility Modifier None Typical Low $134.90 Median $181.97 Typical High $1,202.26 | Facility | None | $134.90 | $181.97 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $186.21 Typical High $323.59 | Professional | None | $125.89 | $186.21 | $323.59 |
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 $85.11 Median $144.54 Typical High $269.15 | Professional | None | $85.11 | $144.54 | $269.15 |
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 $47.86 Median $64.57 Typical High $70.79 | Professional | 52 · Reduced service | $47.86 | $64.57 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.05 Median $25.70 Typical High $28.84 | Professional | 53 · Discontinued | $19.05 | $25.70 | $28.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $66.07 Median $91.20 Typical High $100.00 | Professional | 78 · Unplanned return to OR | $66.07 | $91.20 | $100.00 |
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· 36th of 51
$141
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.