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 $239.88 Median $281.84 Typical High $380.19 | Professional | None | $239.88 | $281.84 | $380.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $208.93 Typical High $281.84 | Professional | 54 · Surgery only | $177.83 | $208.93 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $42.66 Typical High $56.23 | Professional | 55 · Aftercare only | $35.48 | $42.66 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $28.18 Typical High $38.02 | Professional | 56 · Pre-op care only | $23.99 | $28.18 | $38.02 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $194.98 Median $338.84 Typical High $537.03 | Professional | None | $194.98 | $338.84 | $537.03 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $204.17 Typical High $316.23 | Professional | 54 · Surgery only | $128.82 | $204.17 | $316.23 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $25.70 Typical High $39.81 | Professional | 55 · Aftercare only | $15.85 | $25.70 | $39.81 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $25.70 Typical High $39.81 | Professional | 56 · Pre-op care only | $15.85 | $25.70 | $39.81 |
Cigna Setting Facility Modifier None Typical Low $269.15 Median $363.08 Typical High $1,071.52 | Facility | None | $269.15 | $363.08 | $1,071.52 |
Cigna Setting Professional Modifier None Typical Low $263.03 Median $467.74 Typical High $794.33 | Professional | None | $263.03 | $467.74 | $794.33 |
United Setting Facility Modifier None Typical Low $97.72 Median $316.23 Typical High $3,890.45 | Facility | None | $97.72 | $316.23 | $3,890.45 |
United Setting Professional Modifier None Typical Low $194.98 Median $316.23 Typical High $660.69 | Professional | None | $194.98 | $316.23 | $660.69 |
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 $120.23 Median $141.25 Typical High $190.55 | Professional | 52 · Reduced service | $120.23 | $141.25 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $56.23 Typical High $75.86 | Professional | 53 · Discontinued | $47.86 | $56.23 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $194.98 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $165.96 | $194.98 | $263.03 |
Where Rhode Island sits
The same service costs 3.5 times more in Alaska than in Maryland. 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· 37th of 51
$339
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.