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 $501.19 Median $501.19 Typical High $501.19 | Professional | None | $501.19 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $380.19 Typical High $380.19 | Professional | 54 · Surgery only | $380.19 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | 55 · Aftercare only | $75.86 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | 56 · Pre-op care only | $50.12 | $50.12 | $50.12 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $380.19 Median $501.19 Typical High $691.83 | Professional | None | $380.19 | $501.19 | $691.83 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $295.12 Typical High $346.74 | Professional | 54 · Surgery only | $245.47 | $295.12 | $346.74 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $91.20 Typical High $107.15 | Professional | 55 · Aftercare only | $74.13 | $91.20 | $107.15 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $42.66 Typical High $50.12 | Professional | 56 · Pre-op care only | $35.48 | $42.66 | $50.12 |
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 $562.34 Median $741.31 Typical High $776.25 | Professional | None | $562.34 | $741.31 | $776.25 |
United Setting Facility Modifier None Typical Low $371.54 Median $1,096.48 Typical High $4,786.30 | Facility | None | $371.54 | $1,096.48 | $4,786.30 |
United Setting Professional Modifier None Typical Low $331.13 Median $416.87 Typical High $758.58 | Professional | None | $331.13 | $416.87 | $758.58 |
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 $251.19 Median $251.19 Typical High $251.19 | Professional | 52 · Reduced service | $251.19 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | 53 · Discontinued | $100.00 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $354.81 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $354.81 | $354.81 | $354.81 |
Where Rhode Island sits
The same service costs 8.1 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· 30th of 51
$501
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.