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 $223.87 Median $316.23 Typical High $398.11 | Professional | None | $223.87 | $316.23 | $398.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $204.17 Typical High $245.47 | Professional | 54 · Surgery only | $169.82 | $204.17 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $40.74 Typical High $48.98 | Professional | 55 · Aftercare only | $33.88 | $40.74 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $26.92 Typical High $32.36 | Professional | 56 · Pre-op care only | $22.39 | $26.92 | $32.36 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $190.55 Median $275.42 Typical High $436.52 | Professional | None | $190.55 | $275.42 | $436.52 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $181.97 Typical High $302.00 | Professional | 54 · Surgery only | $123.03 | $181.97 | $302.00 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $22.91 Typical High $37.15 | Professional | 55 · Aftercare only | $15.49 | $22.91 | $37.15 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $22.91 Typical High $37.15 | Professional | 56 · Pre-op care only | $15.49 | $22.91 | $37.15 |
Cigna Setting Facility Modifier None Typical Low $467.74 Median $616.60 Typical High $1,071.52 | Facility | None | $467.74 | $616.60 | $1,071.52 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $295.12 Typical High $660.69 | Professional | None | $199.53 | $295.12 | $660.69 |
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 $169.82 Median $281.84 Typical High $562.34 | Professional | None | $169.82 | $281.84 | $562.34 |
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 $112.20 Median $134.90 Typical High $162.18 | Professional | 52 · Reduced service | $112.20 | $134.90 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $54.95 Typical High $64.57 | Professional | 53 · Discontinued | $44.67 | $54.95 | $64.57 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $158.49 Median $190.55 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $158.49 | $190.55 | $229.09 |
Where Rhode Island sits
The same service costs 3.6 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· 34th of 51
$302
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.