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 $69.18 Median $89.13 Typical High $120.23 | Professional | None | $69.18 | $89.13 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $53.70 Median $60.26 Typical High $74.13 | Professional | 54 · Surgery only | $53.70 | $60.26 | $74.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $12.30 Typical High $14.79 | Professional | 55 · Aftercare only | $10.72 | $12.30 | $14.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $8.13 Typical High $10.00 | Professional | 56 · Pre-op care only | $7.24 | $8.13 | $10.00 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $60.26 Median $85.11 Typical High $138.04 | Professional | None | $60.26 | $85.11 | $138.04 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $39.81 Median $56.23 Typical High $95.50 | Professional | 54 · Surgery only | $39.81 | $56.23 | $95.50 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $5.01 Median $7.08 Typical High $12.02 | Professional | 55 · Aftercare only | $5.01 | $7.08 | $12.02 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $5.01 Median $7.08 Typical High $12.02 | Professional | 56 · Pre-op care only | $5.01 | $7.08 | $12.02 |
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 $66.07 Median $95.50 Typical High $204.17 | Professional | None | $66.07 | $95.50 | $204.17 |
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 $61.66 Median $93.33 Typical High $169.82 | Professional | None | $61.66 | $93.33 | $169.82 |
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 $35.48 Median $40.74 Typical High $50.12 | Professional | 52 · Reduced service | $35.48 | $40.74 | $50.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $16.22 Typical High $19.95 | Professional | 53 · Discontinued | $14.45 | $16.22 | $19.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $50.12 Median $56.23 Typical High $69.18 | Professional | 78 · Unplanned return to OR | $50.12 | $56.23 | $69.18 |
Where Rhode Island sits
The same service costs 3.8 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
$95.50
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.