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 $177.83 Median $223.87 Typical High $281.84 | Professional | None | $177.83 | $223.87 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $144.54 Typical High $173.78 | Professional | 54 · Surgery only | $138.04 | $144.54 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $28.84 Typical High $34.67 | Professional | 55 · Aftercare only | $27.54 | $28.84 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $19.50 Typical High $22.91 | Professional | 56 · Pre-op care only | $18.62 | $19.50 | $22.91 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $162.18 Median $204.17 Typical High $323.59 | Professional | None | $162.18 | $204.17 | $323.59 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $144.54 Typical High $229.09 | Professional | 54 · Surgery only | $104.71 | $144.54 | $229.09 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $17.78 Typical High $28.84 | Professional | 55 · Aftercare only | $13.18 | $17.78 | $28.84 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $17.78 Typical High $28.84 | Professional | 56 · Pre-op care only | $13.18 | $17.78 | $28.84 |
Cigna Setting Facility Modifier None Typical Low $173.78 Median $234.42 Typical High $794.33 | Facility | None | $173.78 | $234.42 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $169.82 Median $218.78 Typical High $478.63 | Professional | None | $169.82 | $218.78 | $478.63 |
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 $151.36 Median $229.09 Typical High $398.11 | Professional | None | $151.36 | $229.09 | $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 $93.33 Median $95.50 Typical High $114.82 | Professional | 52 · Reduced service | $93.33 | $95.50 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $38.90 Typical High $46.77 | Professional | 53 · Discontinued | $37.15 | $38.90 | $46.77 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $128.82 Median $134.90 Typical High $162.18 | Professional | 78 · Unplanned return to OR | $128.82 | $134.90 | $162.18 |
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
$229
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.