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 $190.55 Median $218.78 Typical High $302.00 | Professional | None | $190.55 | $218.78 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $162.18 Typical High $223.87 | Professional | 54 · Surgery only | $144.54 | $162.18 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $32.36 Typical High $45.71 | Professional | 55 · Aftercare only | $28.84 | $32.36 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $21.88 Typical High $30.20 | Professional | 56 · Pre-op care only | $19.05 | $21.88 | $30.20 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $162.18 Median $257.04 Typical High $302.00 | Professional | None | $162.18 | $257.04 | $302.00 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $151.36 Typical High $239.88 | Professional | 54 · Surgery only | $107.15 | $151.36 | $239.88 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $19.05 Typical High $30.20 | Professional | 55 · Aftercare only | $13.18 | $19.05 | $30.20 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $19.05 Typical High $30.20 | Professional | 56 · Pre-op care only | $13.18 | $19.05 | $30.20 |
Cigna Setting Facility Modifier None Typical Low $199.53 Median $269.15 Typical High $794.33 | Facility | None | $199.53 | $269.15 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $234.42 Median $295.12 Typical High $398.11 | Professional | None | $234.42 | $295.12 | $398.11 |
United Setting Facility Modifier None Typical Low $645.65 Median $1,445.44 Typical High $5,754.40 | Facility | None | $645.65 | $1,445.44 | $5,754.40 |
United Setting Professional Modifier None Typical Low $138.04 Median $218.78 Typical High $302.00 | Professional | None | $138.04 | $218.78 | $302.00 |
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 $95.50 Median $109.65 Typical High $151.36 | Professional | 52 · Reduced service | $95.50 | $109.65 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $43.65 Typical High $60.26 | Professional | 53 · Discontinued | $38.90 | $43.65 | $60.26 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $134.90 Median $151.36 Typical High $208.93 | Professional | 78 · Unplanned return to OR | $134.90 | $151.36 | $208.93 |
Where Rhode Island sits
The same service costs 3.5 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· 27th of 51
$234
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.