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 $144.54 Median $186.21 Typical High $239.88 | Professional | None | $144.54 | $186.21 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $120.23 Typical High $144.54 | Professional | 54 · Surgery only | $114.82 | $120.23 | $144.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $23.99 Typical High $29.51 | Professional | 55 · Aftercare only | $22.91 | $23.99 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $16.22 Typical High $19.50 | Professional | 56 · Pre-op care only | $15.14 | $16.22 | $19.50 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $131.83 Median $173.78 Typical High $275.42 | Professional | None | $131.83 | $173.78 | $275.42 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $123.03 Typical High $194.98 | Professional | 54 · Surgery only | $87.10 | $123.03 | $194.98 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $15.14 Typical High $24.55 | Professional | 55 · Aftercare only | $10.96 | $15.14 | $24.55 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $15.14 Typical High $24.55 | Professional | 56 · Pre-op care only | $10.96 | $15.14 | $24.55 |
Cigna Setting Facility Modifier None Typical Low $154.88 Median $213.80 Typical High $794.33 | Facility | None | $154.88 | $213.80 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $186.21 Typical High $407.38 | Professional | None | $138.04 | $186.21 | $407.38 |
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 $123.03 Median $190.55 Typical High $338.84 | Professional | None | $123.03 | $190.55 | $338.84 |
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 $75.86 Median $81.28 Typical High $97.72 | Professional | 52 · Reduced service | $75.86 | $81.28 | $97.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $32.36 Typical High $38.90 | Professional | 53 · Discontinued | $30.20 | $32.36 | $38.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $107.15 Median $112.20 Typical High $134.90 | Professional | 78 · Unplanned return to OR | $107.15 | $112.20 | $134.90 |
Where Rhode Island sits
The same service costs 3.9 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· 28th of 51
$195
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.