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 $331.13 Median $380.19 Typical High $501.19 | Professional | None | $331.13 | $380.19 | $501.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $281.84 Typical High $371.54 | Professional | 54 · Surgery only | $251.19 | $281.84 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $56.23 Typical High $74.13 | Professional | 55 · Aftercare only | $50.12 | $56.23 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $38.02 Typical High $50.12 | Professional | 56 · Pre-op care only | $33.11 | $38.02 | $50.12 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $257.04 Median $389.05 Typical High $537.03 | Professional | None | $257.04 | $389.05 | $537.03 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $218.78 Typical High $316.23 | Professional | 54 · Surgery only | $147.91 | $218.78 | $316.23 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $67.61 Typical High $95.50 | Professional | 55 · Aftercare only | $44.67 | $67.61 | $95.50 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $31.62 Typical High $45.71 | Professional | 56 · Pre-op care only | $21.38 | $31.62 | $45.71 |
Cigna Setting Facility Modifier None Typical Low $288.40 Median $389.05 Typical High $1,202.26 | Facility | None | $288.40 | $389.05 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $524.81 Typical High $691.83 | Professional | None | $446.68 | $524.81 | $691.83 |
United Setting Facility Modifier None Typical Low $870.96 Median $2,089.30 Typical High $5,888.44 | Facility | None | $870.96 | $2,089.30 | $5,888.44 |
United Setting Professional Modifier None Typical Low $218.78 Median $354.81 Typical High $630.96 | Professional | None | $218.78 | $354.81 | $630.96 |
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 $165.96 Median $190.55 Typical High $251.19 | Professional | 52 · Reduced service | $165.96 | $190.55 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $75.86 Typical High $100.00 | Professional | 53 · Discontinued | $67.61 | $75.86 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $263.03 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $234.42 | $263.03 | $346.74 |
Where Rhode Island sits
The same service costs 4.3 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· 19th of 51
$447
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.