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 $3,715.35 Median $3,715.35 Typical High $3,981.07 | Facility | None | $3,715.35 | $3,715.35 | $3,981.07 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $398.11 Typical High $467.74 | Professional | None | $338.84 | $398.11 | $467.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $295.12 Typical High $354.81 | Professional | 54 · Surgery only | $257.04 | $295.12 | $354.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $58.88 Typical High $70.79 | Professional | 55 · Aftercare only | $51.29 | $58.88 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $39.81 Typical High $46.77 | Professional | 56 · Pre-op care only | $33.88 | $39.81 | $46.77 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $354.81 Median $489.78 Typical High $645.65 | Professional | None | $354.81 | $489.78 | $645.65 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $338.84 Typical High $512.86 | Professional | 54 · Surgery only | $234.42 | $338.84 | $512.86 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $41.69 Typical High $64.57 | Professional | 55 · Aftercare only | $29.51 | $41.69 | $64.57 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $37.15 Typical High $57.54 | Professional | 56 · Pre-op care only | $26.30 | $37.15 | $57.54 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $645.65 Typical High $1,202.26 | Facility | None | $478.63 | $645.65 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $501.19 Median $616.60 Typical High $794.33 | Professional | None | $501.19 | $616.60 | $794.33 |
United Setting Facility Modifier None Typical Low $933.25 Median $3,548.13 Typical High $10,232.93 | Facility | None | $933.25 | $3,548.13 | $10,232.93 |
United Setting Professional Modifier None Typical Low $251.19 Median $338.84 Typical High $575.44 | Professional | None | $251.19 | $338.84 | $575.44 |
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 $169.82 Median $194.98 Typical High $234.42 | Professional | 52 · Reduced service | $169.82 | $194.98 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $79.43 Typical High $93.33 | Professional | 53 · Discontinued | $67.61 | $79.43 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $275.42 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $239.88 | $275.42 | $331.13 |
Where Rhode Island sits
The same service costs 4.3 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· 24th of 51
$468
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.