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 $309.03 Median $338.84 Typical High $338.84 | Professional | None | $309.03 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $257.04 Typical High $257.04 | Professional | 54 · Surgery only | $229.09 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $51.29 Typical High $51.29 | Professional | 55 · Aftercare only | $45.71 | $51.29 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $33.88 Typical High $33.88 | Professional | 56 · Pre-op care only | $30.90 | $33.88 | $33.88 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $257.04 Median $331.13 Typical High $501.19 | Professional | None | $257.04 | $331.13 | $501.19 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $190.55 Typical High $251.19 | Professional | 54 · Surgery only | $158.49 | $190.55 | $251.19 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $58.88 Typical High $77.62 | Professional | 55 · Aftercare only | $47.86 | $58.88 | $77.62 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $28.18 Typical High $37.15 | Professional | 56 · Pre-op care only | $22.91 | $28.18 | $37.15 |
Cigna Setting Facility Modifier None Typical Low $162.18 Median $218.78 Typical High $1,202.26 | Facility | None | $162.18 | $218.78 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $407.38 Median $467.74 Typical High $537.03 | Professional | None | $407.38 | $467.74 | $537.03 |
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 $208.93 Median $263.03 Typical High $512.86 | Professional | None | $208.93 | $263.03 | $512.86 |
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 $154.88 Median $169.82 Typical High $169.82 | Professional | 52 · Reduced service | $154.88 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $69.18 Typical High $69.18 | Professional | 53 · Discontinued | $61.66 | $69.18 | $69.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $213.80 Median $239.88 Typical High $239.88 | Professional | 78 · Unplanned return to OR | $213.80 | $239.88 | $239.88 |
Where Rhode Island sits
The same service costs 5.4 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· 27th of 51
$339
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.