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 $245.47 Median $269.15 Typical High $316.23 | Professional | None | $245.47 | $269.15 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $204.17 Typical High $204.17 | Professional | 54 · Surgery only | $181.97 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $40.74 Typical High $40.74 | Professional | 55 · Aftercare only | $36.31 | $40.74 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $26.92 Typical High $26.92 | Professional | 56 · Pre-op care only | $24.55 | $26.92 | $26.92 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $190.55 Median $257.04 Typical High $380.19 | Professional | None | $190.55 | $257.04 | $380.19 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $151.36 Typical High $186.21 | Professional | 54 · Surgery only | $123.03 | $151.36 | $186.21 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $45.71 Typical High $57.54 | Professional | 55 · Aftercare only | $38.02 | $45.71 | $57.54 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $21.88 Typical High $26.92 | Professional | 56 · Pre-op care only | $17.78 | $21.88 | $26.92 |
Cigna Setting Facility Modifier None Typical Low $162.18 Median $218.78 Typical High $1,202.26 | Facility | None | $162.18 | $218.78 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $371.54 Typical High $436.52 | Professional | None | $309.03 | $371.54 | $436.52 |
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 $165.96 Median $218.78 Typical High $389.05 | Professional | None | $165.96 | $218.78 | $389.05 |
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 $123.03 Median $134.90 Typical High $134.90 | Professional | 52 · Reduced service | $123.03 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $53.70 Typical High $53.70 | Professional | 53 · Discontinued | $48.98 | $53.70 | $53.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $169.82 Median $190.55 Typical High $190.55 | Professional | 78 · Unplanned return to OR | $169.82 | $190.55 | $190.55 |
Where Rhode Island sits
The same service costs 5.1 times more in Alaska than in Utah. 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· 25th of 51
$269
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.