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 $3,715.35 Median $3,715.35 Typical High $3,981.07 | Facility | None | $3,715.35 | $3,715.35 | $3,981.07 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $234.42 Typical High $275.42 | Professional | None | $158.49 | $234.42 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $162.18 Typical High $208.93 | Professional | 54 · Surgery only | $117.49 | $162.18 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $32.36 Typical High $41.69 | Professional | 55 · Aftercare only | $23.44 | $32.36 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $21.88 Typical High $27.54 | Professional | 56 · Pre-op care only | $15.85 | $21.88 | $27.54 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $213.80 Median $316.23 Typical High $426.58 | Professional | None | $213.80 | $316.23 | $426.58 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $199.53 Typical High $338.84 | Professional | 54 · Surgery only | $141.25 | $199.53 | $338.84 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $25.12 Typical High $42.66 | Professional | 55 · Aftercare only | $17.38 | $25.12 | $42.66 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $25.12 Typical High $42.66 | Professional | 56 · Pre-op care only | $17.38 | $25.12 | $42.66 |
Cigna Setting Facility Modifier None Typical Low $354.81 Median $478.63 Typical High $1,202.26 | Facility | None | $354.81 | $478.63 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $389.05 Typical High $537.03 | Professional | None | $309.03 | $389.05 | $537.03 |
United Setting Facility Modifier None Typical Low $371.54 Median $1,096.48 Typical High $4,265.80 | Facility | None | $371.54 | $1,096.48 | $4,265.80 |
United Setting Professional Modifier None Typical Low $123.03 Median $194.98 Typical High $389.05 | Professional | None | $123.03 | $194.98 | $389.05 |
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 $79.43 Median $109.65 Typical High $138.04 | Professional | 52 · Reduced service | $79.43 | $109.65 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $43.65 Typical High $54.95 | Professional | 53 · Discontinued | $31.62 | $43.65 | $54.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $109.65 Median $151.36 Typical High $194.98 | Professional | 78 · Unplanned return to OR | $109.65 | $151.36 | $194.98 |
Where Rhode Island sits
The same service costs 4.5 times more in Alaska than in Kentucky. 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· 31st of 51
$275
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.