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 $97.72 Median $112.20 Typical High $131.83 | Professional | None | $97.72 | $112.20 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $74.13 Median $85.11 Typical High $97.72 | Professional | 54 · Surgery only | $74.13 | $85.11 | $97.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $16.98 Typical High $19.50 | Professional | 55 · Aftercare only | $14.79 | $16.98 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $11.22 Typical High $12.88 | Professional | 56 · Pre-op care only | $9.77 | $11.22 | $12.88 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $81.28 Median $112.20 Typical High $162.18 | Professional | None | $81.28 | $112.20 | $162.18 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $52.48 Median $79.43 Typical High $114.82 | Professional | 54 · Surgery only | $52.48 | $79.43 | $114.82 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $10.00 Typical High $14.13 | Professional | 55 · Aftercare only | $6.61 | $10.00 | $14.13 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $10.00 Typical High $14.13 | Professional | 56 · Pre-op care only | $6.61 | $10.00 | $14.13 |
Cigna Setting Facility Modifier None Typical Low $107.15 Median $147.91 Typical High $794.33 | Facility | None | $107.15 | $147.91 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $141.25 Median $162.18 Typical High $213.80 | Professional | None | $141.25 | $162.18 | $213.80 |
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 $66.07 Median $107.15 Typical High $190.55 | Professional | None | $66.07 | $107.15 | $190.55 |
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 $48.98 Median $56.23 Typical High $64.57 | Professional | 52 · Reduced service | $48.98 | $56.23 | $64.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $22.39 Typical High $26.30 | Professional | 53 · Discontinued | $19.50 | $22.39 | $26.30 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $69.18 Median $79.43 Typical High $91.20 | Professional | 78 · Unplanned return to OR | $69.18 | $79.43 | $91.20 |
Where Rhode Island sits
The same service costs 3.7 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· 22nd of 51
$129
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.