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 $331.13 Typical High $426.58 | Professional | None | $251.19 | $331.13 | $426.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $239.88 Typical High $281.84 | Professional | 54 · Surgery only | $218.78 | $239.88 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $47.86 Typical High $56.23 | Professional | 55 · Aftercare only | $43.65 | $47.86 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $31.62 Typical High $38.02 | Professional | 56 · Pre-op care only | $29.51 | $31.62 | $38.02 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $213.80 Median $346.74 Typical High $549.54 | Professional | None | $213.80 | $346.74 | $549.54 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $223.87 Typical High $346.74 | Professional | 54 · Surgery only | $141.25 | $223.87 | $346.74 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $28.18 Typical High $43.65 | Professional | 55 · Aftercare only | $17.78 | $28.18 | $43.65 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $28.18 Typical High $43.65 | Professional | 56 · Pre-op care only | $17.78 | $28.18 | $43.65 |
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 $288.40 Median $478.63 Typical High $831.76 | Professional | None | $288.40 | $478.63 | $831.76 |
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 $346.74 Typical High $691.83 | Professional | None | $223.87 | $346.74 | $691.83 |
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 $147.91 Median $158.49 Typical High $190.55 | Professional | 52 · Reduced service | $147.91 | $158.49 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $63.10 Typical High $75.86 | Professional | 53 · Discontinued | $58.88 | $63.10 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $204.17 Median $223.87 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $204.17 | $223.87 | $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· 26th of 51
$372
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.