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 $3,715.35 Median $3,715.35 Typical High $3,981.07 | Facility | None | $3,715.35 | $3,715.35 | $3,981.07 |
Aetna Setting Professional Modifier None Typical Low $44.67 Median $50.12 Typical High $51.29 | Professional | None | $44.67 | $50.12 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $37.15 Median $37.15 Typical High $38.90 | Professional | 54 · Surgery only | $37.15 | $37.15 | $38.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.41 Median $7.41 Typical High $7.76 | Professional | 55 · Aftercare only | $7.41 | $7.41 | $7.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.01 Median $5.01 Typical High $5.25 | Professional | 56 · Pre-op care only | $5.01 | $5.01 | $5.25 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $39.81 Median $48.98 Typical High $85.11 | Professional | None | $39.81 | $48.98 | $85.11 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $25.12 Median $33.11 Typical High $58.88 | Professional | 54 · Surgery only | $25.12 | $33.11 | $58.88 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $3.16 Median $4.17 Typical High $7.24 | Professional | 55 · Aftercare only | $3.16 | $4.17 | $7.24 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $3.16 Median $4.17 Typical High $7.24 | Professional | 56 · Pre-op care only | $3.16 | $4.17 | $7.24 |
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 $45.71 Median $54.95 Typical High $109.65 | Professional | None | $45.71 | $54.95 | $109.65 |
United Setting Facility Modifier None Typical Low $97.72 Median $204.17 Typical High $3,890.45 | Facility | None | $97.72 | $204.17 | $3,890.45 |
United Setting Professional Modifier None Typical Low $39.81 Median $53.70 Typical High $93.33 | Professional | None | $39.81 | $53.70 | $93.33 |
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 $25.12 Median $25.12 Typical High $25.70 | Professional | 52 · Reduced service | $25.12 | $25.12 | $25.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.00 Median $10.00 Typical High $10.47 | Professional | 53 · Discontinued | $10.00 | $10.00 | $10.47 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $34.67 Median $34.67 Typical High $36.31 | Professional | 78 · Unplanned return to OR | $34.67 | $34.67 | $36.31 |
Where Rhode Island sits
The same service costs 4.6 times more in Alaska than in New York. 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· 41st of 51
$51.29
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.