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 $117.49 Median $123.03 Typical High $144.54 | Professional | None | $117.49 | $123.03 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $93.33 Typical High $107.15 | Professional | 54 · Surgery only | $87.10 | $93.33 | $107.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $18.62 Typical High $21.38 | Professional | 55 · Aftercare only | $17.38 | $18.62 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $12.30 Typical High $14.45 | Professional | 56 · Pre-op care only | $11.75 | $12.30 | $14.45 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $93.33 Median $128.82 Typical High $173.78 | Professional | None | $93.33 | $128.82 | $173.78 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $60.26 Median $87.10 Typical High $120.23 | Professional | 54 · Surgery only | $60.26 | $87.10 | $120.23 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $10.96 Typical High $15.14 | Professional | 55 · Aftercare only | $7.59 | $10.96 | $15.14 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $10.96 Typical High $15.14 | Professional | 56 · Pre-op care only | $7.59 | $10.96 | $15.14 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $131.83 Typical High $1,202.26 | Facility | None | $100.00 | $131.83 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $181.97 Typical High $218.78 | Professional | None | $154.88 | $181.97 | $218.78 |
United Setting Facility Modifier None Typical Low $645.65 Median $1,445.44 Typical High $5,011.87 | Facility | None | $645.65 | $1,445.44 | $5,011.87 |
United Setting Professional Modifier None Typical Low $74.13 Median $120.23 Typical High $204.17 | Professional | None | $74.13 | $120.23 | $204.17 |
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 $57.54 Median $61.66 Typical High $72.44 | Professional | 52 · Reduced service | $57.54 | $61.66 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $24.55 Typical High $28.84 | Professional | 53 · Discontinued | $23.44 | $24.55 | $28.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $81.28 Median $87.10 Typical High $100.00 | Professional | 78 · Unplanned return to OR | $81.28 | $87.10 | $100.00 |
Where Rhode Island sits
The same service costs 4.0 times more in Alaska than in Florida. 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· 23rd of 51
$145
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.