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 $123.03 Median $177.83 Typical High $229.09 | Professional | None | $123.03 | $177.83 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $109.65 Typical High $138.04 | Professional | 54 · Surgery only | $93.33 | $109.65 | $138.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $22.39 Typical High $27.54 | Professional | 55 · Aftercare only | $18.62 | $22.39 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $14.79 Typical High $18.20 | Professional | 56 · Pre-op care only | $12.30 | $14.79 | $18.20 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $93.33 Median $151.36 Typical High $251.19 | Professional | None | $93.33 | $151.36 | $251.19 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $61.66 Median $100.00 Typical High $162.18 | Professional | 54 · Surgery only | $61.66 | $100.00 | $162.18 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $7.76 Median $12.59 Typical High $19.95 | Professional | 55 · Aftercare only | $7.76 | $12.59 | $19.95 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $12.59 Typical High $19.95 | Professional | 56 · Pre-op care only | $7.76 | $12.59 | $19.95 |
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 $102.33 Median $169.82 Typical High $371.54 | Professional | None | $102.33 | $169.82 | $371.54 |
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 $100.00 Median $154.88 Typical High $316.23 | Professional | None | $100.00 | $154.88 | $316.23 |
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 $61.66 Median $74.13 Typical High $91.20 | Professional | 52 · Reduced service | $61.66 | $74.13 | $91.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $29.51 Typical High $36.31 | Professional | 53 · Discontinued | $24.55 | $29.51 | $36.31 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $87.10 Median $102.33 Typical High $128.82 | Professional | 78 · Unplanned return to OR | $87.10 | $102.33 | $128.82 |
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· 37th of 51
$162
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.