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 $128.82 Median $173.78 Typical High $223.87 | Professional | None | $128.82 | $173.78 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $95.50 Typical High $128.82 | Professional | 54 · Surgery only | $95.50 | $95.50 | $128.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $19.50 Typical High $26.30 | Professional | 55 · Aftercare only | $19.50 | $19.50 | $26.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $12.88 Typical High $17.38 | Professional | 56 · Pre-op care only | $12.88 | $12.88 | $17.38 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $117.49 Median $173.78 Typical High $229.09 | Professional | None | $117.49 | $173.78 | $229.09 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $128.82 Typical High $181.97 | Professional | 54 · Surgery only | $75.86 | $128.82 | $181.97 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $16.22 Typical High $22.91 | Professional | 55 · Aftercare only | $9.55 | $16.22 | $22.91 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $16.22 Typical High $22.91 | Professional | 56 · Pre-op care only | $9.55 | $16.22 | $22.91 |
Cigna Setting Facility Modifier None Typical Low $134.90 Median $181.97 Typical High $794.33 | Facility | None | $134.90 | $181.97 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $194.98 Median $223.87 Typical High $338.84 | Professional | None | $194.98 | $223.87 | $338.84 |
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 $109.65 Median $154.88 Typical High $234.42 | Professional | None | $109.65 | $154.88 | $234.42 |
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 $64.57 Median $64.57 Typical High $87.10 | Professional | 52 · Reduced service | $64.57 | $64.57 | $87.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $25.70 Typical High $34.67 | Professional | 53 · Discontinued | $25.70 | $25.70 | $34.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $89.13 Median $89.13 Typical High $120.23 | Professional | 78 · Unplanned return to OR | $89.13 | $89.13 | $120.23 |
Where Rhode Island sits
The same service costs 3.6 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
$174
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.