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 $371.54 Median $407.38 Typical High $416.87 | Professional | None | $371.54 | $407.38 | $416.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $309.03 Typical High $309.03 | Professional | 54 · Surgery only | $275.42 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $61.66 Typical High $61.66 | Professional | 55 · Aftercare only | $56.23 | $61.66 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $40.74 Typical High $40.74 | Professional | 56 · Pre-op care only | $37.15 | $40.74 | $40.74 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $288.40 Median $380.19 Typical High $562.34 | Professional | None | $288.40 | $380.19 | $562.34 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $223.87 Typical High $281.84 | Professional | 54 · Surgery only | $181.97 | $223.87 | $281.84 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $67.61 Typical High $87.10 | Professional | 55 · Aftercare only | $56.23 | $67.61 | $87.10 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $32.36 Typical High $40.74 | Professional | 56 · Pre-op care only | $26.30 | $32.36 | $40.74 |
Cigna Setting Facility Modifier None Typical Low $162.18 Median $223.87 Typical High $794.33 | Facility | None | $162.18 | $223.87 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $549.54 Typical High $630.96 | Professional | None | $457.09 | $549.54 | $630.96 |
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 $245.47 Median $316.23 Typical High $575.44 | Professional | None | $245.47 | $316.23 | $575.44 |
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 $186.21 Median $204.17 Typical High $204.17 | Professional | 52 · Reduced service | $186.21 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $81.28 Typical High $81.28 | Professional | 53 · Discontinued | $74.13 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $288.40 Typical High $288.40 | Professional | 78 · Unplanned return to OR | $257.04 | $288.40 | $288.40 |
Where Rhode Island sits
The same service costs 5.8 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· 25th of 51
$407
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.