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 $114.82 Median $151.36 Typical High $199.53 | Professional | None | $114.82 | $151.36 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $112.20 Typical High $147.91 | Professional | 54 · Surgery only | $87.10 | $112.20 | $147.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $22.39 Typical High $29.51 | Professional | 55 · Aftercare only | $17.38 | $22.39 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $15.14 Typical High $19.95 | Professional | 56 · Pre-op care only | $11.48 | $15.14 | $19.95 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $114.82 Median $181.97 Typical High $316.23 | Professional | None | $114.82 | $181.97 | $316.23 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $74.13 Median $123.03 Typical High $177.83 | Professional | 54 · Surgery only | $74.13 | $123.03 | $177.83 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $15.49 Typical High $22.39 | Professional | 55 · Aftercare only | $9.33 | $15.49 | $22.39 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $15.49 Typical High $22.39 | Professional | 56 · Pre-op care only | $9.33 | $15.49 | $22.39 |
Cigna Setting Facility Modifier None Typical Low $154.88 Median $208.93 Typical High $1,202.26 | Facility | None | $154.88 | $208.93 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $234.42 Typical High $389.05 | Professional | None | $162.18 | $234.42 | $389.05 |
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 $107.15 Median $162.18 Typical High $275.42 | Professional | None | $107.15 | $162.18 | $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 $57.54 Median $74.13 Typical High $100.00 | Professional | 52 · Reduced service | $57.54 | $74.13 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $30.20 Typical High $39.81 | Professional | 53 · Discontinued | $22.91 | $30.20 | $39.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $81.28 Median $104.71 Typical High $138.04 | Professional | 78 · Unplanned return to OR | $81.28 | $104.71 | $138.04 |
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· 34th 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.