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 $2,089.30 Median $2,754.23 Typical High $3,981.07 | Facility | None | $2,089.30 | $2,754.23 | $3,981.07 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $354.81 Typical High $489.78 | Professional | None | $316.23 | $354.81 | $489.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $269.15 Typical High $371.54 | Professional | 54 · Surgery only | $239.88 | $269.15 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $53.70 Typical High $74.13 | Professional | 55 · Aftercare only | $47.86 | $53.70 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $35.48 Typical High $48.98 | Professional | 56 · Pre-op care only | $31.62 | $35.48 | $48.98 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $239.88 Median $354.81 Typical High $512.86 | Professional | None | $239.88 | $354.81 | $512.86 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $208.93 Typical High $302.00 | Professional | 54 · Surgery only | $138.04 | $208.93 | $302.00 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $64.57 Typical High $91.20 | Professional | 55 · Aftercare only | $41.69 | $64.57 | $91.20 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $30.90 Typical High $43.65 | Professional | 56 · Pre-op care only | $19.95 | $30.90 | $43.65 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $2,137.96 Typical High $3,090.30 | Facility | None | $588.84 | $2,137.96 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $489.78 Typical High $660.69 | Professional | None | $416.87 | $489.78 | $660.69 |
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 $204.17 Median $338.84 Typical High $616.60 | Professional | None | $204.17 | $338.84 | $616.60 |
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 $158.49 Median $177.83 Typical High $245.47 | Professional | 52 · Reduced service | $158.49 | $177.83 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $70.79 Typical High $97.72 | Professional | 53 · Discontinued | $64.57 | $70.79 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $251.19 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $223.87 | $251.19 | $346.74 |
Where Rhode Island sits
The same service costs 5.5 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· 23rd of 51
$417
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.