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 $162.18 Median $204.17 Typical High $275.42 | Professional | None | $162.18 | $204.17 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $141.25 Typical High $165.96 | Professional | 54 · Surgery only | $125.89 | $141.25 | $165.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $28.18 Typical High $33.11 | Professional | 55 · Aftercare only | $25.12 | $28.18 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $19.05 Typical High $22.39 | Professional | 56 · Pre-op care only | $16.60 | $19.05 | $22.39 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $147.91 Median $199.53 Typical High $316.23 | Professional | None | $147.91 | $199.53 | $316.23 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $138.04 Typical High $223.87 | Professional | 54 · Surgery only | $97.72 | $138.04 | $223.87 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $17.38 Typical High $28.18 | Professional | 55 · Aftercare only | $12.30 | $17.38 | $28.18 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $17.38 Typical High $28.18 | Professional | 56 · Pre-op care only | $12.30 | $17.38 | $28.18 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $977.24 Typical High $1,380.38 | Facility | None | $446.68 | $977.24 | $1,380.38 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $213.80 Typical High $467.74 | Professional | None | $154.88 | $213.80 | $467.74 |
United Setting Facility Modifier None Typical Low $645.65 Median $1,445.44 Typical High $5,011.87 | Facility | None | $645.65 | $1,445.44 | $5,011.87 |
United Setting Professional Modifier None Typical Low $141.25 Median $208.93 Typical High $398.11 | Professional | None | $141.25 | $208.93 | $398.11 |
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 $93.33 Typical High $109.65 | Professional | 52 · Reduced service | $83.18 | $93.33 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $38.02 Typical High $44.67 | Professional | 53 · Discontinued | $33.11 | $38.02 | $44.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $117.49 Median $131.83 Typical High $154.88 | Professional | 78 · Unplanned return to OR | $117.49 | $131.83 | $154.88 |
Where Rhode Island sits
The same service costs 4.6 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· 31st 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.