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 $194.98 Median $223.87 Typical High $223.87 | Professional | None | $194.98 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $169.82 Typical High $169.82 | Professional | 54 · Surgery only | $144.54 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $33.88 Typical High $33.88 | Professional | 55 · Aftercare only | $28.84 | $33.88 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $22.39 Typical High $22.39 | Professional | 56 · Pre-op care only | $19.50 | $22.39 | $22.39 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $158.49 Median $190.55 Typical High $302.00 | Professional | None | $158.49 | $190.55 | $302.00 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $91.20 Median $117.49 Typical High $154.88 | Professional | 54 · Surgery only | $91.20 | $117.49 | $154.88 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $35.48 Typical High $46.77 | Professional | 55 · Aftercare only | $27.54 | $35.48 | $46.77 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $16.98 Typical High $22.39 | Professional | 56 · Pre-op care only | $13.18 | $16.98 | $22.39 |
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 $251.19 Median $269.15 Typical High $323.59 | Professional | None | $251.19 | $269.15 | $323.59 |
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 $128.82 Median $169.82 Typical High $316.23 | Professional | None | $128.82 | $169.82 | $316.23 |
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 $97.72 Median $112.20 Typical High $112.20 | Professional | 52 · Reduced service | $97.72 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $44.67 Typical High $44.67 | Professional | 53 · Discontinued | $38.90 | $44.67 | $44.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $134.90 Median $158.49 Typical High $158.49 | Professional | 78 · Unplanned return to OR | $134.90 | $158.49 | $158.49 |
Where Rhode Island sits
The same service costs 4.6 times more in Alaska than in Florida. 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· 20th of 51
$224
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.