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 $186.21 Median $208.93 Typical High $257.04 | Professional | None | $186.21 | $208.93 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $158.49 Typical High $194.98 | Professional | 54 · Surgery only | $141.25 | $158.49 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $31.62 Typical High $38.90 | Professional | 55 · Aftercare only | $28.18 | $31.62 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $20.89 Typical High $25.70 | Professional | 56 · Pre-op care only | $18.62 | $20.89 | $25.70 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $141.25 Median $208.93 Typical High $346.74 | Professional | None | $141.25 | $208.93 | $346.74 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $138.04 Typical High $234.42 | Professional | 54 · Surgery only | $93.33 | $138.04 | $234.42 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $16.98 Typical High $29.51 | Professional | 55 · Aftercare only | $11.75 | $16.98 | $29.51 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $16.98 Typical High $29.51 | Professional | 56 · Pre-op care only | $11.75 | $16.98 | $29.51 |
Cigna Setting Facility Modifier None Typical Low $173.78 Median $239.88 Typical High $794.33 | Facility | None | $173.78 | $239.88 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $234.42 Typical High $512.86 | Professional | None | $154.88 | $234.42 | $512.86 |
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 $151.36 Median $229.09 Typical High $436.52 | Professional | None | $151.36 | $229.09 | $436.52 |
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 $93.33 Median $104.71 Typical High $128.82 | Professional | 52 · Reduced service | $93.33 | $104.71 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $42.66 Typical High $51.29 | Professional | 53 · Discontinued | $38.02 | $42.66 | $51.29 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $131.83 Median $147.91 Typical High $181.97 | Professional | 78 · Unplanned return to OR | $131.83 | $147.91 | $181.97 |
Where Rhode Island sits
The same service costs 3.5 times more in Alaska than in Texas. 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· 31st of 51
$234
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.