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 $234.42 Median $309.03 Typical High $416.87 | Professional | None | $234.42 | $309.03 | $416.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $218.78 Typical High $263.03 | Professional | 54 · Surgery only | $190.55 | $218.78 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $43.65 Typical High $52.48 | Professional | 55 · Aftercare only | $38.02 | $43.65 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $29.51 Typical High $34.67 | Professional | 56 · Pre-op care only | $25.12 | $29.51 | $34.67 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $208.93 Median $302.00 Typical High $478.63 | Professional | None | $208.93 | $302.00 | $478.63 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $199.53 Typical High $331.13 | Professional | 54 · Surgery only | $138.04 | $199.53 | $331.13 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $24.55 Typical High $41.69 | Professional | 55 · Aftercare only | $17.38 | $24.55 | $41.69 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $24.55 Typical High $41.69 | Professional | 56 · Pre-op care only | $17.38 | $24.55 | $41.69 |
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 $223.87 Median $323.59 Typical High $707.95 | Professional | None | $223.87 | $323.59 | $707.95 |
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 $199.53 Median $316.23 Typical High $602.56 | Professional | None | $199.53 | $316.23 | $602.56 |
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 $125.89 Median $147.91 Typical High $173.78 | Professional | 52 · Reduced service | $125.89 | $147.91 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $58.88 Typical High $70.79 | Professional | 53 · Discontinued | $50.12 | $58.88 | $70.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $177.83 Median $204.17 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $177.83 | $204.17 | $245.47 |
Where Rhode Island sits
The same service costs 4.0 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· 32nd of 51
$339
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.