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 $107.15 Median $151.36 Typical High $194.98 | Professional | None | $107.15 | $151.36 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $79.43 Median $95.50 Typical High $114.82 | Professional | 54 · Surgery only | $79.43 | $95.50 | $114.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $19.05 Typical High $22.91 | Professional | 55 · Aftercare only | $15.85 | $19.05 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $12.59 Typical High $15.14 | Professional | 56 · Pre-op care only | $10.72 | $12.59 | $15.14 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $95.50 Median $138.04 Typical High $218.78 | Professional | None | $95.50 | $138.04 | $218.78 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $63.10 Median $91.20 Typical High $144.54 | Professional | 54 · Surgery only | $63.10 | $91.20 | $144.54 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $7.76 Median $11.48 Typical High $18.20 | Professional | 55 · Aftercare only | $7.76 | $11.48 | $18.20 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $11.48 Typical High $18.20 | Professional | 56 · Pre-op care only | $7.76 | $11.48 | $18.20 |
Cigna Setting Facility Modifier None Typical Low $131.83 Median $177.83 Typical High $794.33 | Facility | None | $131.83 | $177.83 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $100.00 Median $151.36 Typical High $323.59 | Professional | None | $100.00 | $151.36 | $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 $141.25 Typical High $269.15 | Professional | None | $85.11 | $141.25 | $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 $53.70 Median $63.10 Typical High $75.86 | Professional | 52 · Reduced service | $53.70 | $63.10 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $25.70 Typical High $30.20 | Professional | 53 · Discontinued | $21.38 | $25.70 | $30.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $74.13 Median $89.13 Typical High $107.15 | Professional | 78 · Unplanned return to OR | $74.13 | $89.13 | $107.15 |
Where Rhode Island sits
The same service costs 3.7 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· 26th of 51
$151
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.