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 $141.25 Median $158.49 Typical High $190.55 | Professional | None | $141.25 | $158.49 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $107.15 Typical High $141.25 | Professional | 54 · Surgery only | $104.71 | $107.15 | $141.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $21.38 Typical High $28.84 | Professional | 55 · Aftercare only | $20.89 | $21.38 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $14.45 Typical High $19.05 | Professional | 56 · Pre-op care only | $14.13 | $14.45 | $19.05 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $128.82 Median $165.96 Typical High $194.98 | Professional | None | $128.82 | $165.96 | $194.98 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $120.23 Typical High $158.49 | Professional | 54 · Surgery only | $83.18 | $120.23 | $158.49 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $15.14 Typical High $19.50 | Professional | 55 · Aftercare only | $10.47 | $15.14 | $19.50 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $15.14 Typical High $19.50 | Professional | 56 · Pre-op care only | $10.47 | $15.14 | $19.50 |
Cigna Setting Facility Modifier None Typical Low $120.23 Median $162.18 Typical High $794.33 | Facility | None | $120.23 | $162.18 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $190.55 Typical High $245.47 | Professional | None | $181.97 | $190.55 | $245.47 |
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 $102.33 Median $138.04 Typical High $190.55 | Professional | None | $102.33 | $138.04 | $190.55 |
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 $69.18 Median $72.44 Typical High $95.50 | Professional | 52 · Reduced service | $69.18 | $72.44 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $28.84 Typical High $38.02 | Professional | 53 · Discontinued | $28.18 | $28.84 | $38.02 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $97.72 Median $100.00 Typical High $131.83 | Professional | 78 · Unplanned return to OR | $97.72 | $100.00 | $131.83 |
Where Rhode Island sits
The same service costs 4.0 times more in Alaska than in New Jersey. 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· 23rd of 51
$170
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.