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 $114.82 Median $158.49 Typical High $218.78 | Professional | None | $114.82 | $158.49 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $100.00 Typical High $120.23 | Professional | 54 · Surgery only | $87.10 | $100.00 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $19.95 Typical High $23.99 | Professional | 55 · Aftercare only | $17.38 | $19.95 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $13.49 Typical High $16.22 | Professional | 56 · Pre-op care only | $11.48 | $13.49 | $16.22 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $97.72 Median $141.25 Typical High $229.09 | Professional | None | $97.72 | $141.25 | $229.09 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $64.57 Median $93.33 Typical High $154.88 | Professional | 54 · Surgery only | $64.57 | $93.33 | $154.88 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $11.75 Typical High $19.05 | Professional | 55 · Aftercare only | $8.13 | $11.75 | $19.05 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $11.75 Typical High $19.05 | Professional | 56 · Pre-op care only | $8.13 | $11.75 | $19.05 |
Cigna Setting Facility Modifier None Typical Low $128.82 Median $173.78 Typical High $794.33 | Facility | None | $128.82 | $173.78 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $154.88 Typical High $338.84 | Professional | None | $102.33 | $154.88 | $338.84 |
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 $93.33 Median $151.36 Typical High $281.84 | Professional | None | $93.33 | $151.36 | $281.84 |
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 $57.54 Median $66.07 Typical High $81.28 | Professional | 52 · Reduced service | $57.54 | $66.07 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $26.92 Typical High $32.36 | Professional | 53 · Discontinued | $22.91 | $26.92 | $32.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $81.28 Median $93.33 Typical High $112.20 | Professional | 78 · Unplanned return to OR | $81.28 | $93.33 | $112.20 |
Where Rhode Island sits
The same service costs 3.5 times more in Alaska than in Florida. 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· 31st of 51
$155
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.