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 $181.97 Median $251.19 Typical High $316.23 | Professional | None | $181.97 | $251.19 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $190.55 Typical High $234.42 | Professional | 54 · Surgery only | $134.90 | $190.55 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $38.02 Typical High $46.77 | Professional | 55 · Aftercare only | $27.54 | $38.02 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $25.12 Typical High $31.62 | Professional | 56 · Pre-op care only | $18.20 | $25.12 | $31.62 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $186.21 Median $275.42 Typical High $331.13 | Professional | None | $186.21 | $275.42 | $331.13 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $181.97 Typical High $263.03 | Professional | 54 · Surgery only | $104.71 | $181.97 | $263.03 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $22.91 Typical High $33.11 | Professional | 55 · Aftercare only | $12.88 | $22.91 | $33.11 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $22.91 Typical High $33.11 | Professional | 56 · Pre-op care only | $12.88 | $22.91 | $33.11 |
Cigna Setting Facility Modifier None Typical Low $245.47 Median $338.84 Typical High $794.33 | Facility | None | $245.47 | $338.84 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $239.88 Median $281.84 Typical High $524.81 | Professional | None | $239.88 | $281.84 | $524.81 |
United Setting Facility Modifier None Typical Low $645.65 Median $1,445.44 Typical High $5,011.87 | Facility | None | $645.65 | $1,445.44 | $5,011.87 |
United Setting Professional Modifier None Typical Low $123.03 Median $251.19 Typical High $389.05 | Professional | None | $123.03 | $251.19 | $389.05 |
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 $91.20 Median $125.89 Typical High $158.49 | Professional | 52 · Reduced service | $91.20 | $125.89 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $50.12 Typical High $63.10 | Professional | 53 · Discontinued | $36.31 | $50.12 | $63.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $125.89 Median $177.83 Typical High $218.78 | Professional | 78 · Unplanned return to OR | $125.89 | $177.83 | $218.78 |
Where Rhode Island sits
The same service costs 3.8 times more in Wyoming 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· 28th of 51
$282
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.