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 $229.09 Median $302.00 Typical High $363.08 | Professional | None | $229.09 | $302.00 | $363.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $208.93 Typical High $269.15 | Professional | 54 · Surgery only | $169.82 | $208.93 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $41.69 Typical High $54.95 | Professional | 55 · Aftercare only | $33.88 | $41.69 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $28.18 Typical High $36.31 | Professional | 56 · Pre-op care only | $22.91 | $28.18 | $36.31 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $234.42 Median $363.08 Typical High $478.63 | Professional | None | $234.42 | $363.08 | $478.63 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $229.09 Typical High $380.19 | Professional | 54 · Surgery only | $154.88 | $229.09 | $380.19 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $28.84 Typical High $47.86 | Professional | 55 · Aftercare only | $19.50 | $28.84 | $47.86 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $28.84 Typical High $47.86 | Professional | 56 · Pre-op care only | $19.50 | $28.84 | $47.86 |
Cigna Setting Facility Modifier None Typical Low $346.74 Median $478.63 Typical High $1,202.26 | Facility | None | $346.74 | $478.63 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $426.58 Typical High $602.56 | Professional | None | $331.13 | $426.58 | $602.56 |
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 $177.83 Median $263.03 Typical High $436.52 | Professional | None | $177.83 | $263.03 | $436.52 |
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 $112.20 Median $141.25 Typical High $181.97 | Professional | 52 · Reduced service | $112.20 | $141.25 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $56.23 Typical High $72.44 | Professional | 53 · Discontinued | $45.71 | $56.23 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $158.49 Median $194.98 Typical High $251.19 | Professional | 78 · Unplanned return to OR | $158.49 | $194.98 | $251.19 |
Where Rhode Island sits
The same service costs 3.5 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· 28th of 51
$331
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.