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 $302.00 Median $331.13 Typical High $331.13 | Professional | None | $302.00 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $223.87 Median $251.19 Typical High $251.19 | Professional | 54 · Surgery only | $223.87 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $50.12 Typical High $50.12 | Professional | 55 · Aftercare only | $44.67 | $50.12 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $33.11 Typical High $33.11 | Professional | 56 · Pre-op care only | $30.20 | $33.11 | $33.11 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $223.87 Median $281.84 Typical High $436.52 | Professional | None | $223.87 | $281.84 | $436.52 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $165.96 Typical High $223.87 | Professional | 54 · Surgery only | $138.04 | $165.96 | $223.87 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $51.29 Typical High $67.61 | Professional | 55 · Aftercare only | $41.69 | $51.29 | $67.61 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $23.99 Typical High $32.36 | Professional | 56 · Pre-op care only | $19.95 | $23.99 | $32.36 |
Cigna Setting Facility Modifier None Typical Low $162.18 Median $218.78 Typical High $1,202.26 | Facility | None | $162.18 | $218.78 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $380.19 Median $407.38 Typical High $478.63 | Professional | None | $380.19 | $407.38 | $478.63 |
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 $194.98 Median $269.15 Typical High $457.09 | Professional | None | $194.98 | $269.15 | $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 $151.36 Median $165.96 Typical High $165.96 | Professional | 52 · Reduced service | $151.36 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $66.07 Typical High $66.07 | Professional | 53 · Discontinued | $60.26 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $208.93 Median $234.42 Typical High $234.42 | Professional | 78 · Unplanned return to OR | $208.93 | $234.42 | $234.42 |
Where Rhode Island sits
The same service costs 5.1 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· 22nd of 51
$324
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.