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 $251.19 Median $309.03 Typical High $467.74 | Professional | None | $251.19 | $309.03 | $467.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $204.17 Typical High $234.42 | Professional | 54 · Surgery only | $186.21 | $204.17 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $40.74 Typical High $46.77 | Professional | 55 · Aftercare only | $37.15 | $40.74 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $27.54 Typical High $31.62 | Professional | 56 · Pre-op care only | $25.12 | $27.54 | $31.62 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $223.87 Median $281.84 Typical High $446.68 | Professional | None | $223.87 | $281.84 | $446.68 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $199.53 Typical High $323.59 | Professional | 54 · Surgery only | $144.54 | $199.53 | $323.59 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $25.12 Typical High $40.74 | Professional | 55 · Aftercare only | $18.20 | $25.12 | $40.74 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $25.12 Typical High $40.74 | Professional | 56 · Pre-op care only | $18.20 | $25.12 | $40.74 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $1,047.13 Typical High $1,380.38 | Facility | None | $588.84 | $1,047.13 | $1,380.38 |
Cigna Setting Professional Modifier None Typical Low $234.42 Median $309.03 Typical High $676.08 | Professional | None | $234.42 | $309.03 | $676.08 |
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 $199.53 Median $302.00 Typical High $562.34 | Professional | None | $199.53 | $302.00 | $562.34 |
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 $125.89 Median $138.04 Typical High $158.49 | Professional | 52 · Reduced service | $125.89 | $138.04 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $54.95 Typical High $63.10 | Professional | 53 · Discontinued | $50.12 | $54.95 | $63.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $173.78 Median $190.55 Typical High $218.78 | Professional | 78 · Unplanned return to OR | $173.78 | $190.55 | $218.78 |
Where Rhode Island sits
The same service costs 4.8 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· 35th of 51
$316
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.