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 $2,398.83 Median $3,235.94 Typical High $3,981.07 | Facility | None | $2,398.83 | $3,235.94 | $3,981.07 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $870.96 Typical High $1,258.93 | Professional | None | $537.03 | $870.96 | $1,258.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $537.03 Typical High $741.31 | Professional | 54 · Surgery only | $398.11 | $537.03 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $107.15 Typical High $151.36 | Professional | 55 · Aftercare only | $79.43 | $107.15 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $72.44 Typical High $100.00 | Professional | 56 · Pre-op care only | $53.70 | $72.44 | $100.00 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $363.08 Median $630.96 Typical High $1,380.38 | Professional | None | $363.08 | $630.96 | $1,380.38 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $363.08 Typical High $1,023.29 | Professional | 54 · Surgery only | $239.88 | $363.08 | $1,023.29 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $45.71 Typical High $85.11 | Professional | 55 · Aftercare only | $30.20 | $45.71 | $85.11 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $45.71 Typical High $109.65 | Professional | 56 · Pre-op care only | $30.20 | $45.71 | $109.65 |
Cigna Setting Facility Modifier None Typical Low $302.00 Median $416.87 Typical High $1,412.54 | Facility | None | $302.00 | $416.87 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $758.58 Typical High $1,096.48 | Professional | None | $512.86 | $758.58 | $1,096.48 |
United Setting Facility Modifier None Typical Low $812.83 Median $2,630.27 Typical High $7,762.47 | Facility | None | $812.83 | $2,630.27 | $7,762.47 |
United Setting Professional Modifier None Typical Low $416.87 Median $660.69 Typical High $912.01 | Professional | None | $416.87 | $660.69 | $912.01 |
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 $263.03 Median $354.81 Typical High $501.19 | Professional | 52 · Reduced service | $263.03 | $354.81 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $144.54 Typical High $199.53 | Professional | 53 · Discontinued | $107.15 | $144.54 | $199.53 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $501.19 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $371.54 | $501.19 | $691.83 |
Where Rhode Island sits
The same service costs 4.3 times more in Wisconsin 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· 28th of 51
$724
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.