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 $331.13 Median $389.05 Typical High $436.52 | Professional | None | $331.13 | $389.05 | $436.52 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $295.12 Typical High $331.13 | Professional | 54 · Surgery only | $251.19 | $295.12 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $58.88 Typical High $66.07 | Professional | 55 · Aftercare only | $50.12 | $58.88 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $38.90 Typical High $43.65 | Professional | 56 · Pre-op care only | $33.11 | $38.90 | $43.65 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $269.15 Median $380.19 Typical High $524.81 | Professional | None | $269.15 | $380.19 | $524.81 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $218.78 Typical High $309.03 | Professional | 54 · Surgery only | $154.88 | $218.78 | $309.03 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $66.07 Typical High $95.50 | Professional | 55 · Aftercare only | $46.77 | $66.07 | $95.50 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $31.62 Typical High $44.67 | Professional | 56 · Pre-op care only | $22.39 | $31.62 | $44.67 |
Cigna Setting Facility Modifier None Typical Low $269.15 Median $446.68 Typical High $1,202.26 | Facility | None | $269.15 | $446.68 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $537.03 Typical High $676.08 | Professional | None | $457.09 | $537.03 | $676.08 |
United Setting Facility Modifier None Typical Low $371.54 Median $1,096.48 Typical High $4,265.80 | Facility | None | $371.54 | $1,096.48 | $4,265.80 |
United Setting Professional Modifier None Typical Low $223.87 Median $338.84 Typical High $616.60 | Professional | None | $223.87 | $338.84 | $616.60 |
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 $165.96 Median $194.98 Typical High $218.78 | Professional | 52 · Reduced service | $165.96 | $194.98 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $77.62 Typical High $87.10 | Professional | 53 · Discontinued | $66.07 | $77.62 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $275.42 Typical High $309.03 | Professional | 78 · Unplanned return to OR | $234.42 | $275.42 | $309.03 |
Where Rhode Island sits
The same service costs 4.5 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· 16th of 51
$437
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.