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 $234.42 Median $269.15 Typical High $354.81 | Professional | None | $234.42 | $269.15 | $354.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $199.53 Typical High $263.03 | Professional | 54 · Surgery only | $177.83 | $199.53 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $39.81 Typical High $52.48 | Professional | 55 · Aftercare only | $35.48 | $39.81 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $26.92 Typical High $35.48 | Professional | 56 · Pre-op care only | $23.44 | $26.92 | $35.48 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $177.83 Median $269.15 Typical High $389.05 | Professional | None | $177.83 | $269.15 | $389.05 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $181.97 Typical High $263.03 | Professional | 54 · Surgery only | $117.49 | $181.97 | $263.03 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $22.91 Typical High $32.36 | Professional | 55 · Aftercare only | $14.79 | $22.91 | $32.36 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $22.91 Typical High $32.36 | Professional | 56 · Pre-op care only | $14.79 | $22.91 | $32.36 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $977.24 Typical High $1,380.38 | Facility | None | $446.68 | $977.24 | $1,380.38 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $371.54 Typical High $501.19 | Professional | None | $309.03 | $371.54 | $501.19 |
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 $151.36 Median $245.47 Typical High $457.09 | Professional | None | $151.36 | $245.47 | $457.09 |
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 $117.49 Median $134.90 Typical High $177.83 | Professional | 52 · Reduced service | $117.49 | $134.90 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $53.70 Typical High $70.79 | Professional | 53 · Discontinued | $46.77 | $53.70 | $70.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $186.21 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $165.96 | $186.21 | $245.47 |
Where Rhode Island sits
The same service costs 4.1 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· 20th of 51
$309
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.