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 $125.89 Median $177.83 Typical High $213.80 | Professional | None | $125.89 | $177.83 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $102.33 Median $123.03 Typical High $151.36 | Professional | 54 · Surgery only | $102.33 | $123.03 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $24.55 Typical High $30.20 | Professional | 55 · Aftercare only | $20.42 | $24.55 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $16.22 Typical High $19.95 | Professional | 56 · Pre-op care only | $13.80 | $16.22 | $19.95 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $104.71 Median $162.18 Typical High $275.42 | Professional | None | $104.71 | $162.18 | $275.42 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $67.61 Median $107.15 Typical High $177.83 | Professional | 54 · Surgery only | $67.61 | $107.15 | $177.83 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $13.49 Typical High $22.39 | Professional | 55 · Aftercare only | $8.51 | $13.49 | $22.39 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $13.49 Typical High $22.39 | Professional | 56 · Pre-op care only | $8.51 | $13.49 | $22.39 |
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 $114.82 Median $186.21 Typical High $407.38 | Professional | None | $114.82 | $186.21 | $407.38 |
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 $109.65 Median $169.82 Typical High $338.84 | Professional | None | $109.65 | $169.82 | $338.84 |
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 $69.18 Median $81.28 Typical High $100.00 | Professional | 52 · Reduced service | $69.18 | $81.28 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $32.36 Typical High $39.81 | Professional | 53 · Discontinued | $27.54 | $32.36 | $39.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $95.50 Median $114.82 Typical High $141.25 | Professional | 78 · Unplanned return to OR | $95.50 | $114.82 | $141.25 |
Where Rhode Island sits
The same service costs 3.3 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· 35th of 51
$178
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.