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 $165.96 Typical High $208.93 | Professional | None | $141.25 | $165.96 | $208.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $123.03 Typical High $154.88 | Professional | 54 · Surgery only | $107.15 | $123.03 | $154.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $24.55 Typical High $30.90 | Professional | 55 · Aftercare only | $21.38 | $24.55 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $16.22 Typical High $20.89 | Professional | 56 · Pre-op care only | $14.13 | $16.22 | $20.89 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $125.89 Median $199.53 Typical High $239.88 | Professional | None | $125.89 | $199.53 | $239.88 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $117.49 Typical High $190.55 | Professional | 54 · Surgery only | $81.28 | $117.49 | $190.55 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $14.79 Typical High $23.99 | Professional | 55 · Aftercare only | $10.23 | $14.79 | $23.99 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $14.79 Typical High $23.99 | Professional | 56 · Pre-op care only | $10.23 | $14.79 | $23.99 |
Cigna Setting Facility Modifier None Typical Low $151.36 Median $204.17 Typical High $1,202.26 | Facility | None | $151.36 | $204.17 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $229.09 Typical High $302.00 | Professional | None | $177.83 | $229.09 | $302.00 |
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 $100.00 Median $147.91 Typical High $229.09 | Professional | None | $100.00 | $147.91 | $229.09 |
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 $70.79 Median $81.28 Typical High $104.71 | Professional | 52 · Reduced service | $70.79 | $81.28 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $32.36 Typical High $41.69 | Professional | 53 · Discontinued | $28.18 | $32.36 | $41.69 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $100.00 Median $114.82 Typical High $144.54 | Professional | 78 · Unplanned return to OR | $100.00 | $114.82 | $144.54 |
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· 28th of 51
$178
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.