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 $208.93 Median $234.42 Typical High $338.84 | Professional | None | $208.93 | $234.42 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $177.83 Typical High $257.04 | Professional | 54 · Surgery only | $154.88 | $177.83 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $35.48 Typical High $51.29 | Professional | 55 · Aftercare only | $30.90 | $35.48 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $23.44 Typical High $33.88 | Professional | 56 · Pre-op care only | $20.89 | $23.44 | $33.88 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $158.49 Median $239.88 Typical High $371.54 | Professional | None | $158.49 | $239.88 | $371.54 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $177.83 Typical High $251.19 | Professional | 54 · Surgery only | $104.71 | $177.83 | $251.19 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $22.39 Typical High $31.62 | Professional | 55 · Aftercare only | $13.18 | $22.39 | $31.62 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $22.39 Typical High $31.62 | Professional | 56 · Pre-op care only | $13.18 | $22.39 | $31.62 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $977.24 Typical High $1,380.38 | Facility | None | $446.68 | $977.24 | $1,380.38 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $331.13 Typical High $489.78 | Professional | None | $275.42 | $331.13 | $489.78 |
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 $134.90 Median $229.09 Typical High $416.87 | Professional | None | $134.90 | $229.09 | $416.87 |
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 $104.71 Median $117.49 Typical High $169.82 | Professional | 52 · Reduced service | $104.71 | $117.49 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $47.86 Typical High $67.61 | Professional | 53 · Discontinued | $41.69 | $47.86 | $67.61 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $144.54 Median $165.96 Typical High $239.88 | Professional | 78 · Unplanned return to OR | $144.54 | $165.96 | $239.88 |
Where Rhode Island sits
The same service costs 4.5 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· 24th of 51
$275
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.