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 $281.84 Median $331.13 Typical High $389.05 | Professional | None | $281.84 | $331.13 | $389.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $251.19 Typical High $295.12 | Professional | 54 · Surgery only | $208.93 | $251.19 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $50.12 Typical High $58.88 | Professional | 55 · Aftercare only | $41.69 | $50.12 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $33.11 Typical High $38.90 | Professional | 56 · Pre-op care only | $28.18 | $33.11 | $38.90 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $234.42 Median $338.84 Typical High $562.34 | Professional | None | $234.42 | $338.84 | $562.34 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $223.87 Typical High $371.54 | Professional | 54 · Surgery only | $154.88 | $223.87 | $371.54 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $28.18 Typical High $45.71 | Professional | 55 · Aftercare only | $19.05 | $28.18 | $45.71 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $28.18 Typical High $45.71 | Professional | 56 · Pre-op care only | $19.05 | $28.18 | $45.71 |
Cigna Setting Facility Modifier None Typical Low $354.81 Median $478.63 Typical High $1,071.52 | Facility | None | $354.81 | $478.63 | $1,071.52 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $426.58 Typical High $537.03 | Professional | None | $316.23 | $426.58 | $537.03 |
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 $208.93 Median $295.12 Typical High $467.74 | Professional | None | $208.93 | $295.12 | $467.74 |
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 $141.25 Median $165.96 Typical High $194.98 | Professional | 52 · Reduced service | $141.25 | $165.96 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $66.07 Typical High $79.43 | Professional | 53 · Discontinued | $56.23 | $66.07 | $79.43 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $234.42 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $194.98 | $234.42 | $275.42 |
Where Rhode Island sits
The same service costs 3.7 times more in Wisconsin 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· 32nd 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.