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 $138.04 Median $144.54 Typical High $158.49 | Professional | None | $138.04 | $144.54 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $102.33 Median $102.33 Typical High $120.23 | Professional | 54 · Surgery only | $102.33 | $102.33 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $20.42 Typical High $23.99 | Professional | 55 · Aftercare only | $20.42 | $20.42 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $13.80 Typical High $15.85 | Professional | 56 · Pre-op care only | $13.80 | $13.80 | $15.85 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $123.03 Median $173.78 Typical High $208.93 | Professional | None | $123.03 | $173.78 | $208.93 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $114.82 Typical High $165.96 | Professional | 54 · Surgery only | $81.28 | $114.82 | $165.96 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $14.45 Typical High $20.89 | Professional | 55 · Aftercare only | $10.00 | $14.45 | $20.89 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $14.45 Typical High $20.89 | Professional | 56 · Pre-op care only | $10.00 | $14.45 | $20.89 |
Cigna Setting Facility Modifier None Typical Low $138.04 Median $186.21 Typical High $1,202.26 | Facility | None | $138.04 | $186.21 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $229.09 Typical High $302.00 | Professional | None | $173.78 | $229.09 | $302.00 |
United Setting Facility Modifier None Typical Low $870.96 Median $2,089.30 Typical High $7,079.46 | Facility | None | $870.96 | $2,089.30 | $7,079.46 |
United Setting Professional Modifier None Typical Low $109.65 Median $141.25 Typical High $229.09 | Professional | None | $109.65 | $141.25 | $229.09 |
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 $69.18 Median $69.18 Typical High $79.43 | Professional | 52 · Reduced service | $69.18 | $69.18 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $27.54 Typical High $32.36 | Professional | 53 · Discontinued | $27.54 | $27.54 | $32.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $95.50 Median $95.50 Typical High $112.20 | Professional | 78 · Unplanned return to OR | $95.50 | $95.50 | $112.20 |
Where Rhode Island sits
The same service costs 3.7 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· 34th of 51
$162
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.