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 $144.54 Median $194.98 Typical High $223.87 | Professional | None | $144.54 | $194.98 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $123.03 Typical High $165.96 | Professional | 54 · Surgery only | $107.15 | $123.03 | $165.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $25.12 Typical High $33.11 | Professional | 55 · Aftercare only | $21.38 | $25.12 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $16.60 Typical High $22.39 | Professional | 56 · Pre-op care only | $14.45 | $16.60 | $22.39 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $128.82 Median $186.21 Typical High $323.59 | Professional | None | $128.82 | $186.21 | $323.59 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $123.03 Typical High $194.98 | Professional | 54 · Surgery only | $85.11 | $123.03 | $194.98 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $15.49 Typical High $23.99 | Professional | 55 · Aftercare only | $10.47 | $15.49 | $23.99 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $15.49 Typical High $23.99 | Professional | 56 · Pre-op care only | $10.47 | $15.49 | $23.99 |
Cigna Setting Facility Modifier None Typical Low $162.18 Median $218.78 Typical High $1,202.26 | Facility | None | $162.18 | $218.78 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $257.04 Typical High $398.11 | Professional | None | $181.97 | $257.04 | $398.11 |
United Setting Facility Modifier None Typical Low $371.54 Median $1,096.48 Typical High $4,265.80 | Facility | None | $371.54 | $1,096.48 | $4,265.80 |
United Setting Professional Modifier None Typical Low $112.20 Median $173.78 Typical High $295.12 | Professional | None | $112.20 | $173.78 | $295.12 |
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 $70.79 Median $83.18 Typical High $109.65 | Professional | 52 · Reduced service | $70.79 | $83.18 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $33.11 Typical High $44.67 | Professional | 53 · Discontinued | $28.84 | $33.11 | $44.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $100.00 Median $114.82 Typical High $154.88 | Professional | 78 · Unplanned return to OR | $100.00 | $114.82 | $154.88 |
Where Rhode Island sits
The same service costs 4.1 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· 26th of 51
$204
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.