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 $295.12 | Professional | None | $288.40 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $218.78 Typical High $218.78 | Professional | 54 · Surgery only | $218.78 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $43.65 Typical High $43.65 | Professional | 55 · Aftercare only | $43.65 | $43.65 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $29.51 Typical High $29.51 | Professional | 56 · Pre-op care only | $28.84 | $29.51 | $29.51 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $229.09 Median $302.00 Typical High $416.87 | Professional | None | $229.09 | $302.00 | $416.87 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $177.83 Typical High $208.93 | Professional | 54 · Surgery only | $144.54 | $177.83 | $208.93 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $53.70 Typical High $64.57 | Professional | 55 · Aftercare only | $44.67 | $53.70 | $64.57 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $25.70 Typical High $30.20 | Professional | 56 · Pre-op care only | $21.38 | $25.70 | $30.20 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $1,148.15 Typical High $1,621.81 | Facility | None | $446.68 | $1,148.15 | $1,621.81 |
Cigna Setting Professional Modifier None Typical Low $346.74 Median $436.52 Typical High $478.63 | Professional | None | $346.74 | $436.52 | $478.63 |
United Setting Facility Modifier None Typical Low $645.65 Median $1,445.44 Typical High $5,011.87 | Facility | None | $645.65 | $1,445.44 | $5,011.87 |
United Setting Professional Modifier None Typical Low $194.98 Median $234.42 Typical High $426.58 | Professional | None | $194.98 | $234.42 | $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 $144.54 Median $144.54 Typical High $144.54 | Professional | 52 · Reduced service | $144.54 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $58.88 Typical High $58.88 | Professional | 53 · Discontinued | $57.54 | $58.88 | $58.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $204.17 Median $204.17 Typical High $204.17 | Professional | 78 · Unplanned return to OR | $204.17 | $204.17 | $204.17 |
Where Rhode Island sits
The same service costs 5.4 times more in Alaska than in Utah. 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· 28th of 51
$302
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.