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 $173.78 Median $190.55 Typical High $199.53 | Professional | None | $173.78 | $190.55 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $141.25 Typical High $147.91 | Professional | 54 · Surgery only | $131.83 | $141.25 | $147.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $28.84 Typical High $30.20 | Professional | 55 · Aftercare only | $26.30 | $28.84 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $19.05 Typical High $19.95 | Professional | 56 · Pre-op care only | $17.38 | $19.05 | $19.95 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $128.82 Median $154.88 Typical High $263.03 | Professional | None | $128.82 | $154.88 | $263.03 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $109.65 Typical High $147.91 | Professional | 54 · Surgery only | $85.11 | $109.65 | $147.91 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $13.80 Typical High $18.20 | Professional | 55 · Aftercare only | $10.72 | $13.80 | $18.20 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $13.80 Typical High $18.20 | Professional | 56 · Pre-op care only | $10.72 | $13.80 | $18.20 |
Cigna Setting Facility Modifier None Typical Low $186.21 Median $251.19 Typical High $794.33 | Facility | None | $186.21 | $251.19 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $245.47 Typical High $269.15 | Professional | None | $218.78 | $245.47 | $269.15 |
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 $112.20 Median $158.49 Typical High $275.42 | Professional | None | $112.20 | $158.49 | $275.42 |
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 $87.10 Median $95.50 Typical High $100.00 | Professional | 52 · Reduced service | $87.10 | $95.50 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $38.02 Typical High $39.81 | Professional | 53 · Discontinued | $34.67 | $38.02 | $39.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $123.03 Median $131.83 Typical High $138.04 | Professional | 78 · Unplanned return to OR | $123.03 | $131.83 | $138.04 |
Where Rhode Island sits
The same service costs 3.8 times more in Alaska than in Delaware. 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
$182
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.