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 $169.82 Median $239.88 Typical High $288.40 | Professional | None | $169.82 | $239.88 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $151.36 Typical High $218.78 | Professional | 54 · Surgery only | $128.82 | $151.36 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $30.20 Typical High $43.65 | Professional | 55 · Aftercare only | $25.70 | $30.20 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $20.42 Typical High $28.84 | Professional | 56 · Pre-op care only | $16.98 | $20.42 | $28.84 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $158.49 Median $245.47 Typical High $331.13 | Professional | None | $158.49 | $245.47 | $331.13 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $154.88 Typical High $263.03 | Professional | 54 · Surgery only | $104.71 | $154.88 | $263.03 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $19.50 Typical High $33.11 | Professional | 55 · Aftercare only | $13.18 | $19.50 | $33.11 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $19.50 Typical High $33.11 | Professional | 56 · Pre-op care only | $13.18 | $19.50 | $33.11 |
Cigna Setting Facility Modifier None Typical Low $239.88 Median $323.59 Typical High $794.33 | Facility | None | $239.88 | $323.59 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $223.87 Median $295.12 Typical High $398.11 | Professional | None | $223.87 | $295.12 | $398.11 |
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 $125.89 Median $194.98 Typical High $302.00 | Professional | None | $125.89 | $194.98 | $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 $85.11 Median $102.33 Typical High $144.54 | Professional | 52 · Reduced service | $85.11 | $102.33 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $40.74 Typical High $57.54 | Professional | 53 · Discontinued | $33.88 | $40.74 | $57.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $120.23 Median $141.25 Typical High $204.17 | Professional | 78 · Unplanned return to OR | $120.23 | $141.25 | $204.17 |
Where Rhode Island sits
The same service costs 3.5 times more in Alaska than in Washington, DC. 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
$224
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.