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 $288.40 Median $295.12 Typical High $363.08 | Professional | None | $288.40 | $295.12 | $363.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $218.78 Typical High $269.15 | Professional | 54 · Surgery only | $218.78 | $218.78 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $44.67 Typical High $53.70 | Professional | 55 · Aftercare only | $43.65 | $44.67 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $29.51 Typical High $36.31 | Professional | 56 · Pre-op care only | $29.51 | $29.51 | $36.31 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $234.42 Median $295.12 Typical High $478.63 | Professional | None | $234.42 | $295.12 | $478.63 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $186.21 Typical High $309.03 | Professional | 54 · Surgery only | $138.04 | $186.21 | $309.03 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $48.98 Typical High $83.18 | Professional | 55 · Aftercare only | $37.15 | $48.98 | $83.18 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $25.70 Typical High $43.65 | Professional | 56 · Pre-op care only | $19.50 | $25.70 | $43.65 |
Cigna Setting Facility Modifier None Typical Low $251.19 Median $338.84 Typical High $794.33 | Facility | None | $251.19 | $338.84 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $323.59 Typical High $724.44 | Professional | None | $257.04 | $323.59 | $724.44 |
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 $239.88 Median $380.19 Typical High $602.56 | Professional | None | $239.88 | $380.19 | $602.56 |
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 $144.54 Median $147.91 Typical High $181.97 | Professional | 52 · Reduced service | $144.54 | $147.91 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $58.88 Typical High $72.44 | Professional | 53 · Discontinued | $58.88 | $58.88 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $204.17 Median $204.17 Typical High $251.19 | Professional | 78 · Unplanned return to OR | $204.17 | $204.17 | $251.19 |
Where Rhode Island sits
The same service costs 4.7 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
$347
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.