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 $2,089.30 Median $2,754.23 Typical High $3,981.07 | Facility | None | $2,089.30 | $2,754.23 | $3,981.07 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $234.42 Typical High $338.84 | Professional | None | $186.21 | $234.42 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $151.36 Typical High $177.83 | Professional | 54 · Surgery only | $138.04 | $151.36 | $177.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $30.20 Typical High $35.48 | Professional | 55 · Aftercare only | $28.18 | $30.20 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $20.42 Typical High $23.99 | Professional | 56 · Pre-op care only | $18.62 | $20.42 | $23.99 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $162.18 Median $213.80 Typical High $331.13 | Professional | None | $162.18 | $213.80 | $331.13 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $151.36 Typical High $239.88 | Professional | 54 · Surgery only | $107.15 | $151.36 | $239.88 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $18.62 Typical High $30.20 | Professional | 55 · Aftercare only | $13.49 | $18.62 | $30.20 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $18.62 Typical High $30.20 | Professional | 56 · Pre-op care only | $13.49 | $18.62 | $30.20 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $1,047.13 Typical High $1,380.38 | Facility | None | $588.84 | $1,047.13 | $1,380.38 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $223.87 Typical High $501.19 | Professional | None | $165.96 | $223.87 | $501.19 |
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 $154.88 Median $234.42 Typical High $416.87 | Professional | None | $154.88 | $234.42 | $416.87 |
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 $93.33 Median $100.00 Typical High $120.23 | Professional | 52 · Reduced service | $93.33 | $100.00 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $40.74 Typical High $47.86 | Professional | 53 · Discontinued | $37.15 | $40.74 | $47.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $128.82 Median $141.25 Typical High $165.96 | Professional | 78 · Unplanned return to OR | $128.82 | $141.25 | $165.96 |
Where Rhode Island sits
The same service costs 4.7 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· 35th of 51
$240
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.