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 $194.98 Median $218.78 Typical High $269.15 | Professional | None | $194.98 | $218.78 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $154.88 Typical High $199.53 | Professional | 54 · Surgery only | $147.91 | $154.88 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $31.62 Typical High $39.81 | Professional | 55 · Aftercare only | $29.51 | $31.62 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $20.89 Typical High $26.92 | Professional | 56 · Pre-op care only | $19.50 | $20.89 | $26.92 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $181.97 Median $245.47 Typical High $288.40 | Professional | None | $181.97 | $245.47 | $288.40 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $169.82 Typical High $229.09 | Professional | 54 · Surgery only | $117.49 | $169.82 | $229.09 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $21.38 Typical High $28.84 | Professional | 55 · Aftercare only | $14.79 | $21.38 | $28.84 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $21.38 Typical High $28.84 | Professional | 56 · Pre-op care only | $14.79 | $21.38 | $28.84 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $851.14 Typical High $1,230.27 | Facility | None | $446.68 | $851.14 | $1,230.27 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $281.84 Typical High $363.08 | Professional | None | $257.04 | $281.84 | $363.08 |
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 $144.54 Median $194.98 Typical High $275.42 | Professional | None | $144.54 | $194.98 | $275.42 |
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 $97.72 Median $104.71 Typical High $134.90 | Professional | 52 · Reduced service | $97.72 | $104.71 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $41.69 Typical High $53.70 | Professional | 53 · Discontinued | $38.90 | $41.69 | $53.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $138.04 Median $144.54 Typical High $186.21 | Professional | 78 · Unplanned return to OR | $138.04 | $144.54 | $186.21 |
Where Rhode Island sits
The same service costs 4.2 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
$245
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.