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 $3,715.35 Median $3,981.07 Typical High $5,495.41 | Facility | None | $3,715.35 | $3,981.07 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $1,096.48 Median $1,258.93 Typical High $1,258.93 | Professional | None | $1,096.48 | $1,258.93 | $1,258.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $933.25 Typical High $933.25 | Professional | 54 · Surgery only | $831.76 | $933.25 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $186.21 Typical High $186.21 | Professional | 55 · Aftercare only | $165.96 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $125.89 Typical High $125.89 | Professional | 56 · Pre-op care only | $109.65 | $125.89 | $125.89 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $1,148.15 Median $1,348.96 Typical High $1,905.46 | Professional | None | $1,148.15 | $1,348.96 | $1,905.46 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $933.25 Typical High $1,174.90 | Professional | 54 · Surgery only | $660.69 | $933.25 | $1,174.90 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $269.15 Typical High $338.84 | Professional | 55 · Aftercare only | $190.55 | $269.15 | $338.84 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $134.90 Typical High $169.82 | Professional | 56 · Pre-op care only | $93.33 | $134.90 | $169.82 |
United Setting Facility Modifier None Typical Low $933.25 Median $3,548.13 Typical High $11,748.98 | Facility | None | $933.25 | $3,548.13 | $11,748.98 |
United Setting Professional Modifier None Typical Low $954.99 Median $1,047.13 Typical High $1,737.80 | Professional | None | $954.99 | $1,047.13 | $1,737.80 |
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 $549.54 Median $630.96 Typical High $630.96 | Professional | 52 · Reduced service | $549.54 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $251.19 Typical High $251.19 | Professional | 53 · Discontinued | $223.87 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $870.96 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $776.25 | $870.96 | $870.96 |
Where Rhode Island sits
The same service costs 9.1 times more in Wyoming than in Utah. 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· 35th of 51
$1,259
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.