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 $56.23 Median $74.13 Typical High $100.00 | Professional | None | $56.23 | $74.13 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $43.65 Median $43.65 Typical High $63.10 | Professional | 54 · Surgery only | $43.65 | $43.65 | $63.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $8.71 Typical High $12.59 | Professional | 55 · Aftercare only | $8.71 | $8.71 | $12.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $5.89 Typical High $8.51 | Professional | 56 · Pre-op care only | $5.89 | $5.89 | $8.51 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $46.77 Median $57.54 Typical High $97.72 | Professional | None | $46.77 | $57.54 | $97.72 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $30.90 Median $40.74 Typical High $74.13 | Professional | 54 · Surgery only | $30.90 | $40.74 | $74.13 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $3.89 Median $5.13 Typical High $9.12 | Professional | 55 · Aftercare only | $3.89 | $5.13 | $9.12 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $3.89 Median $5.13 Typical High $9.12 | Professional | 56 · Pre-op care only | $3.89 | $5.13 | $9.12 |
Cigna Setting Facility Modifier None Typical Low $269.15 Median $269.15 Typical High $1,202.26 | Facility | None | $269.15 | $269.15 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $51.29 Median $64.57 Typical High $138.04 | Professional | None | $51.29 | $64.57 | $138.04 |
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 $44.67 Median $70.79 Typical High $114.82 | Professional | None | $44.67 | $70.79 | $114.82 |
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 $29.51 Median $29.51 Typical High $42.66 | Professional | 52 · Reduced service | $29.51 | $29.51 | $42.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.75 Median $11.75 Typical High $16.98 | Professional | 53 · Discontinued | $11.75 | $11.75 | $16.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $40.74 Median $40.74 Typical High $58.88 | Professional | 78 · Unplanned return to OR | $40.74 | $40.74 | $58.88 |
Where Rhode Island sits
The same service costs 4.2 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· 37th of 51
$67.61
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.