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 $3,715.35 Median $3,715.35 Typical High $3,981.07 | Facility | None | $3,715.35 | $3,715.35 | $3,981.07 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $169.82 Typical High $257.04 | Professional | None | $144.54 | $169.82 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $128.82 Typical High $190.55 | Professional | 54 · Surgery only | $109.65 | $128.82 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $25.70 Typical High $38.02 | Professional | 55 · Aftercare only | $21.88 | $25.70 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $16.98 Typical High $25.70 | Professional | 56 · Pre-op care only | $14.45 | $16.98 | $25.70 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $120.23 Median $204.17 Typical High $331.13 | Professional | None | $120.23 | $204.17 | $331.13 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $79.43 Median $125.89 Typical High $194.98 | Professional | 54 · Surgery only | $79.43 | $125.89 | $194.98 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $15.49 Typical High $23.99 | Professional | 55 · Aftercare only | $10.00 | $15.49 | $23.99 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $15.49 Typical High $23.99 | Professional | 56 · Pre-op care only | $10.00 | $15.49 | $23.99 |
Cigna Setting Facility Modifier None Typical Low $269.15 Median $269.15 Typical High $1,202.26 | Facility | None | $269.15 | $269.15 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $223.87 Typical High $501.19 | Professional | None | $125.89 | $223.87 | $501.19 |
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 $117.49 Median $208.93 Typical High $426.58 | Professional | None | $117.49 | $208.93 | $426.58 |
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 $72.44 Median $85.11 Typical High $125.89 | Professional | 52 · Reduced service | $72.44 | $85.11 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $34.67 Typical High $51.29 | Professional | 53 · Discontinued | $29.51 | $34.67 | $51.29 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $102.33 Median $120.23 Typical High $177.83 | Professional | 78 · Unplanned return to OR | $102.33 | $120.23 | $177.83 |
Where Rhode Island sits
The same service costs 3.8 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· 36th of 51
$209
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.