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 $154.88 Median $186.21 Typical High $257.04 | Professional | None | $154.88 | $186.21 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $141.25 Typical High $190.55 | Professional | 54 · Surgery only | $117.49 | $141.25 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $28.18 Typical High $38.02 | Professional | 55 · Aftercare only | $23.44 | $28.18 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $18.62 Typical High $25.70 | Professional | 56 · Pre-op care only | $15.49 | $18.62 | $25.70 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $131.83 Median $213.80 Typical High $363.08 | Professional | None | $131.83 | $213.80 | $363.08 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $141.25 Typical High $204.17 | Professional | 54 · Surgery only | $87.10 | $141.25 | $204.17 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $17.38 Typical High $25.70 | Professional | 55 · Aftercare only | $10.96 | $17.38 | $25.70 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $17.38 Typical High $25.70 | Professional | 56 · Pre-op care only | $10.96 | $17.38 | $25.70 |
Cigna Setting Facility Modifier None Typical Low $199.53 Median $269.15 Typical High $1,202.26 | Facility | None | $199.53 | $269.15 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $186.21 Median $275.42 Typical High $426.58 | Professional | None | $186.21 | $275.42 | $426.58 |
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 $125.89 Median $190.55 Typical High $323.59 | Professional | None | $125.89 | $190.55 | $323.59 |
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 $77.62 Median $93.33 Typical High $128.82 | Professional | 52 · Reduced service | $77.62 | $93.33 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $37.15 Typical High $51.29 | Professional | 53 · Discontinued | $30.90 | $37.15 | $51.29 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $109.65 Median $131.83 Typical High $177.83 | Professional | 78 · Unplanned return to OR | $109.65 | $131.83 | $177.83 |
Where Rhode Island sits
The same service costs 3.9 times more in Oklahoma 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· 33rd of 51
$219
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.