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 $223.87 Median $223.87 Typical High $251.19 | Professional | None | $223.87 | $223.87 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $169.82 Typical High $190.55 | Professional | 54 · Surgery only | $169.82 | $169.82 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $33.88 Typical High $38.02 | Professional | 55 · Aftercare only | $33.88 | $33.88 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $22.39 Typical High $25.12 | Professional | 56 · Pre-op care only | $22.39 | $22.39 | $25.12 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $165.96 Median $204.17 Typical High $346.74 | Professional | None | $165.96 | $204.17 | $346.74 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $162.18 Typical High $251.19 | Professional | 54 · Surgery only | $112.20 | $162.18 | $251.19 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $19.95 Typical High $30.90 | Professional | 55 · Aftercare only | $14.13 | $19.95 | $30.90 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $19.95 Typical High $30.90 | Professional | 56 · Pre-op care only | $14.13 | $19.95 | $30.90 |
Cigna Setting Facility Modifier None Typical Low $107.15 Median $144.54 Typical High $1,202.26 | Facility | None | $107.15 | $144.54 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $239.88 Median $309.03 Typical High $389.05 | Professional | None | $239.88 | $309.03 | $389.05 |
United Setting Facility Modifier None Typical Low $870.96 Median $2,089.30 Typical High $5,888.44 | Facility | None | $870.96 | $2,089.30 | $5,888.44 |
United Setting Professional Modifier None Typical Low $154.88 Median $223.87 Typical High $309.03 | Professional | None | $154.88 | $223.87 | $309.03 |
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 $112.20 Median $112.20 Typical High $125.89 | Professional | 52 · Reduced service | $112.20 | $112.20 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $44.67 Typical High $50.12 | Professional | 53 · Discontinued | $44.67 | $44.67 | $50.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $158.49 Median $158.49 Typical High $177.83 | Professional | 78 · Unplanned return to OR | $158.49 | $158.49 | $177.83 |
Where Rhode Island sits
The same service costs 4.9 times more in Oklahoma than in Florida. 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· 30th of 51
$240
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.