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 $537.03 Median $537.03 Typical High $537.03 | Professional | None | $537.03 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $398.11 Typical High $398.11 | Professional | 54 · Surgery only | $398.11 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $79.43 Typical High $79.43 | Professional | 55 · Aftercare only | $79.43 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $53.70 Typical High $53.70 | Professional | 56 · Pre-op care only | $53.70 | $53.70 | $53.70 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $389.05 Median $512.86 Typical High $707.95 | Professional | None | $389.05 | $512.86 | $707.95 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $302.00 Typical High $354.81 | Professional | 54 · Surgery only | $251.19 | $302.00 | $354.81 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $91.20 Typical High $107.15 | Professional | 55 · Aftercare only | $75.86 | $91.20 | $107.15 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $43.65 Typical High $51.29 | Professional | 56 · Pre-op care only | $36.31 | $43.65 | $51.29 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $2,137.96 Typical High $3,090.30 | Facility | None | $446.68 | $2,137.96 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $575.44 Median $758.58 Typical High $851.14 | Professional | None | $575.44 | $758.58 | $851.14 |
United Setting Facility Modifier None Typical Low $870.96 Median $2,089.30 Typical High $7,244.36 | Facility | None | $870.96 | $2,089.30 | $7,244.36 |
United Setting Professional Modifier None Typical Low $346.74 Median $446.68 Typical High $776.25 | Professional | None | $346.74 | $446.68 | $776.25 |
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 $269.15 Median $269.15 Typical High $269.15 | Professional | 52 · Reduced service | $269.15 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $107.15 Typical High $107.15 | Professional | 53 · Discontinued | $107.15 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $371.54 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $371.54 | $371.54 | $371.54 |
Where Rhode Island sits
The same service costs 8.3 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
$537
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.