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 $204.17 Median $269.15 Typical High $363.08 | Professional | None | $204.17 | $269.15 | $363.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $181.97 Typical High $218.78 | Professional | 54 · Surgery only | $151.36 | $181.97 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $36.31 Typical High $43.65 | Professional | 55 · Aftercare only | $30.20 | $36.31 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $24.55 Typical High $29.51 | Professional | 56 · Pre-op care only | $20.42 | $24.55 | $29.51 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $169.82 Median $251.19 Typical High $389.05 | Professional | None | $169.82 | $251.19 | $389.05 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $162.18 Typical High $269.15 | Professional | 54 · Surgery only | $112.20 | $162.18 | $269.15 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $20.42 Typical High $33.88 | Professional | 55 · Aftercare only | $14.13 | $20.42 | $33.88 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $20.42 Typical High $33.88 | Professional | 56 · Pre-op care only | $14.13 | $20.42 | $33.88 |
Cigna Setting Facility Modifier None Typical Low $208.93 Median $281.84 Typical High $794.33 | Facility | None | $208.93 | $281.84 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $269.15 Typical High $588.84 | Professional | None | $181.97 | $269.15 | $588.84 |
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 $154.88 Median $257.04 Typical High $501.19 | Professional | None | $154.88 | $257.04 | $501.19 |
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 $102.33 Median $123.03 Typical High $147.91 | Professional | 52 · Reduced service | $102.33 | $123.03 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $48.98 Typical High $58.88 | Professional | 53 · Discontinued | $40.74 | $48.98 | $58.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $141.25 Median $169.82 Typical High $204.17 | Professional | 78 · Unplanned return to OR | $141.25 | $169.82 | $204.17 |
Where Rhode Island sits
The same service costs 3.6 times more in Alaska than in Texas. 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
$269
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.