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 $97.72 Median $134.90 Typical High $154.88 | Professional | None | $97.72 | $134.90 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $74.13 Median $87.10 Typical High $112.20 | Professional | 54 · Surgery only | $74.13 | $87.10 | $112.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $17.38 Typical High $22.91 | Professional | 55 · Aftercare only | $14.79 | $17.38 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $11.48 Typical High $15.14 | Professional | 56 · Pre-op care only | $9.77 | $11.48 | $15.14 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $74.13 Median $125.89 Typical High $208.93 | Professional | None | $74.13 | $125.89 | $208.93 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $48.98 Median $81.28 Typical High $125.89 | Professional | 54 · Surgery only | $48.98 | $81.28 | $125.89 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $6.17 Median $10.00 Typical High $15.85 | Professional | 55 · Aftercare only | $6.17 | $10.00 | $15.85 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $10.00 Typical High $15.85 | Professional | 56 · Pre-op care only | $6.17 | $10.00 | $15.85 |
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 $81.28 Median $141.25 Typical High $309.03 | Professional | None | $81.28 | $141.25 | $309.03 |
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 $77.62 Median $123.03 Typical High $257.04 | Professional | None | $77.62 | $123.03 | $257.04 |
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 $48.98 Median $57.54 Typical High $75.86 | Professional | 52 · Reduced service | $48.98 | $57.54 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $23.44 Typical High $30.20 | Professional | 53 · Discontinued | $19.50 | $23.44 | $30.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $69.18 Median $81.28 Typical High $104.71 | Professional | 78 · Unplanned return to OR | $69.18 | $81.28 | $104.71 |
Where Rhode Island sits
The same service costs 3.5 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· 38th of 51
$132
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.