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 $154.88 Median $208.93 Typical High $263.03 | Professional | None | $154.88 | $208.93 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $134.90 Typical High $165.96 | Professional | 54 · Surgery only | $114.82 | $134.90 | $165.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $26.92 Typical High $33.11 | Professional | 55 · Aftercare only | $22.91 | $26.92 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $17.78 Typical High $21.88 | Professional | 56 · Pre-op care only | $15.49 | $17.78 | $21.88 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $117.49 Median $177.83 Typical High $295.12 | Professional | None | $117.49 | $177.83 | $295.12 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $117.49 Typical High $199.53 | Professional | 54 · Surgery only | $75.86 | $117.49 | $199.53 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $14.79 Typical High $25.12 | Professional | 55 · Aftercare only | $9.55 | $14.79 | $25.12 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $14.79 Typical High $25.12 | Professional | 56 · Pre-op care only | $9.55 | $14.79 | $25.12 |
Cigna Setting Facility Modifier None Typical Low $154.88 Median $208.93 Typical High $1,202.26 | Facility | None | $154.88 | $208.93 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $199.53 Typical High $436.52 | Professional | None | $128.82 | $199.53 | $436.52 |
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 $123.03 Median $190.55 Typical High $371.54 | Professional | None | $123.03 | $190.55 | $371.54 |
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 $77.62 Median $89.13 Typical High $109.65 | Professional | 52 · Reduced service | $77.62 | $89.13 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $35.48 Typical High $43.65 | Professional | 53 · Discontinued | $30.90 | $35.48 | $43.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $107.15 Median $125.89 Typical High $154.88 | Professional | 78 · Unplanned return to OR | $107.15 | $125.89 | $154.88 |
Where Rhode Island sits
The same service costs 3.5 times more in Alaska than in Maryland. 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· 29th of 51
$200
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.