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 $457.09 Median $489.78 Typical High $616.60 | Professional | None | $457.09 | $489.78 | $616.60 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $371.54 Typical High $467.74 | Professional | 54 · Surgery only | $338.84 | $371.54 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $74.13 Typical High $93.33 | Professional | 55 · Aftercare only | $67.61 | $74.13 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $48.98 Typical High $61.66 | Professional | 56 · Pre-op care only | $45.71 | $48.98 | $61.66 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $407.38 Median $616.60 Typical High $724.44 | Professional | None | $407.38 | $616.60 | $724.44 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $389.05 Typical High $588.84 | Professional | 54 · Surgery only | $275.42 | $389.05 | $588.84 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $47.86 Typical High $72.44 | Professional | 55 · Aftercare only | $33.88 | $47.86 | $72.44 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $43.65 Typical High $66.07 | Professional | 56 · Pre-op care only | $30.20 | $43.65 | $66.07 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $1,949.84 Typical High $2,754.23 | Facility | None | $446.68 | $1,949.84 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $588.84 Median $707.95 Typical High $912.01 | Professional | None | $588.84 | $707.95 | $912.01 |
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 $338.84 Median $457.09 Typical High $660.69 | Professional | None | $338.84 | $457.09 | $660.69 |
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 $223.87 Median $245.47 Typical High $309.03 | Professional | 52 · Reduced service | $223.87 | $245.47 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $97.72 Typical High $123.03 | Professional | 53 · Discontinued | $91.20 | $97.72 | $123.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $346.74 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $316.23 | $346.74 | $436.52 |
Where Rhode Island sits
The same service costs 3.7 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· 22nd of 51
$589
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.