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 $2,089.30 Median $2,754.23 Typical High $3,981.07 | Facility | None | $2,089.30 | $2,754.23 | $3,981.07 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $186.21 | Professional | None | $162.18 | $162.18 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $120.23 Typical High $138.04 | Professional | 54 · Surgery only | $120.23 | $120.23 | $138.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $23.99 Typical High $27.54 | Professional | 55 · Aftercare only | $23.99 | $23.99 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $16.22 Typical High $18.62 | Professional | 56 · Pre-op care only | $16.22 | $16.22 | $18.62 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $117.49 Median $173.78 Typical High $245.47 | Professional | None | $117.49 | $173.78 | $245.47 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $77.62 Median $114.82 Typical High $186.21 | Professional | 54 · Surgery only | $77.62 | $114.82 | $186.21 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $14.45 Typical High $23.44 | Professional | 55 · Aftercare only | $9.77 | $14.45 | $23.44 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $14.45 Typical High $23.44 | Professional | 56 · Pre-op care only | $9.77 | $14.45 | $23.44 |
Cigna Setting Facility Modifier None Typical Low $109.65 Median $147.91 Typical High $1,202.26 | Facility | None | $109.65 | $147.91 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $239.88 Typical High $302.00 | Professional | None | $181.97 | $239.88 | $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 $123.03 Median $162.18 Typical High $229.09 | Professional | None | $123.03 | $162.18 | $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 $81.28 Median $81.28 Typical High $91.20 | Professional | 52 · Reduced service | $81.28 | $81.28 | $91.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $32.36 Typical High $37.15 | Professional | 53 · Discontinued | $32.36 | $32.36 | $37.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $112.20 Median $112.20 Typical High $128.82 | Professional | 78 · Unplanned return to OR | $112.20 | $112.20 | $128.82 |
Where Rhode Island sits
The same service costs 3.6 times more in Wisconsin than in Texas. 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· 25th of 51
$186
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.