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 $2,398.83 Median $3,235.94 Typical High $3,981.07 | Facility | None | $2,398.83 | $3,235.94 | $3,981.07 |
Aetna Setting Professional Modifier None Typical Low $263.03 Median $371.54 Typical High $436.52 | Professional | None | $263.03 | $371.54 | $436.52 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $223.87 Median $239.88 Typical High $316.23 | Professional | 54 · Surgery only | $223.87 | $239.88 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $48.98 Typical High $63.10 | Professional | 55 · Aftercare only | $45.71 | $48.98 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $32.36 Typical High $41.69 | Professional | 56 · Pre-op care only | $30.20 | $32.36 | $41.69 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $218.78 Median $346.74 Typical High $562.34 | Professional | None | $218.78 | $346.74 | $562.34 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $229.09 Typical High $354.81 | Professional | 54 · Surgery only | $144.54 | $229.09 | $354.81 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $28.84 Typical High $44.67 | Professional | 55 · Aftercare only | $17.78 | $28.84 | $44.67 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $28.84 Typical High $44.67 | Professional | 56 · Pre-op care only | $17.78 | $28.84 | $44.67 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $660.69 Typical High $1,412.54 | Facility | None | $489.78 | $660.69 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $489.78 Typical High $851.14 | Professional | None | $295.12 | $489.78 | $851.14 |
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 $223.87 Median $363.08 Typical High $707.95 | Professional | None | $223.87 | $363.08 | $707.95 |
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 $151.36 Median $162.18 Typical High $208.93 | Professional | 52 · Reduced service | $151.36 | $162.18 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $64.57 Typical High $83.18 | Professional | 53 · Discontinued | $60.26 | $64.57 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $208.93 Median $223.87 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $208.93 | $223.87 | $295.12 |
Where Rhode Island sits
The same service costs 3.3 times more in Alaska than in Utah. 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· 27th of 51
$389
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.