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 $190.55 Median $251.19 Typical High $309.03 | Professional | None | $190.55 | $251.19 | $309.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $162.18 Typical High $213.80 | Professional | 54 · Surgery only | $144.54 | $162.18 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $32.36 Typical High $42.66 | Professional | 55 · Aftercare only | $28.84 | $32.36 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $21.88 Typical High $28.18 | Professional | 56 · Pre-op care only | $19.05 | $21.88 | $28.18 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $151.36 Median $251.19 Typical High $380.19 | Professional | None | $151.36 | $251.19 | $380.19 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $100.00 Median $158.49 Typical High $239.88 | Professional | 54 · Surgery only | $100.00 | $158.49 | $239.88 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $19.95 Typical High $30.20 | Professional | 55 · Aftercare only | $12.30 | $19.95 | $30.20 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $19.95 Typical High $30.20 | Professional | 56 · Pre-op care only | $12.30 | $19.95 | $30.20 |
Cigna Setting Facility Modifier None Typical Low $239.88 Median $275.42 Typical High $1,202.26 | Facility | None | $239.88 | $275.42 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $354.81 Typical High $575.44 | Professional | None | $204.17 | $354.81 | $575.44 |
United Setting Facility Modifier None Typical Low $97.72 Median $316.23 Typical High $3,890.45 | Facility | None | $97.72 | $316.23 | $3,890.45 |
United Setting Professional Modifier None Typical Low $147.91 Median $239.88 Typical High $478.63 | Professional | None | $147.91 | $239.88 | $478.63 |
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 $95.50 Median $109.65 Typical High $141.25 | Professional | 52 · Reduced service | $95.50 | $109.65 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $43.65 Typical High $56.23 | Professional | 53 · Discontinued | $38.02 | $43.65 | $56.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $134.90 Median $151.36 Typical High $199.53 | Professional | 78 · Unplanned return to OR | $134.90 | $151.36 | $199.53 |
Where Rhode Island sits
The same service costs 3.4 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
$257
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.