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 $117.49 Median $165.96 Typical High $229.09 | Professional | None | $117.49 | $165.96 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $89.13 Median $107.15 Typical High $125.89 | Professional | 54 · Surgery only | $89.13 | $107.15 | $125.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $21.38 Typical High $25.70 | Professional | 55 · Aftercare only | $17.78 | $21.38 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $14.13 Typical High $16.98 | Professional | 56 · Pre-op care only | $11.75 | $14.13 | $16.98 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $104.71 Median $154.88 Typical High $239.88 | Professional | None | $104.71 | $154.88 | $239.88 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $67.61 Median $100.00 Typical High $158.49 | Professional | 54 · Surgery only | $67.61 | $100.00 | $158.49 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $12.59 Typical High $19.95 | Professional | 55 · Aftercare only | $8.51 | $12.59 | $19.95 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $12.59 Typical High $19.95 | Professional | 56 · Pre-op care only | $8.51 | $12.59 | $19.95 |
Cigna Setting Facility Modifier None Typical Low $141.25 Median $194.98 Typical High $794.33 | Facility | None | $141.25 | $194.98 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $109.65 Median $165.96 Typical High $354.81 | Professional | None | $109.65 | $165.96 | $354.81 |
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 $100.00 Median $162.18 Typical High $302.00 | Professional | None | $100.00 | $162.18 | $302.00 |
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 $58.88 Median $70.79 Typical High $85.11 | Professional | 52 · Reduced service | $58.88 | $70.79 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $28.18 Typical High $33.88 | Professional | 53 · Discontinued | $23.44 | $28.18 | $33.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $83.18 Median $100.00 Typical High $117.49 | Professional | 78 · Unplanned return to OR | $83.18 | $100.00 | $117.49 |
Where Rhode Island sits
The same service costs 3.8 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· 29th of 51
$166
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.