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 $144.54 Median $177.83 Typical High $218.78 | Professional | None | $144.54 | $177.83 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $125.89 Typical High $162.18 | Professional | 54 · Surgery only | $107.15 | $125.89 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $25.12 Typical High $32.36 | Professional | 55 · Aftercare only | $21.38 | $25.12 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $16.98 Typical High $21.88 | Professional | 56 · Pre-op care only | $14.45 | $16.98 | $21.88 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $125.89 Median $199.53 Typical High $251.19 | Professional | None | $125.89 | $199.53 | $251.19 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $120.23 Typical High $199.53 | Professional | 54 · Surgery only | $83.18 | $120.23 | $199.53 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $15.14 Typical High $25.12 | Professional | 55 · Aftercare only | $10.47 | $15.14 | $25.12 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $15.14 Typical High $25.12 | Professional | 56 · Pre-op care only | $10.47 | $15.14 | $25.12 |
Cigna Setting Facility Modifier None Typical Low $162.18 Median $223.87 Typical High $1,071.52 | Facility | None | $162.18 | $223.87 | $1,071.52 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $234.42 Typical High $316.23 | Professional | None | $181.97 | $234.42 | $316.23 |
United Setting Facility Modifier None Typical Low $645.65 Median $1,445.44 Typical High $5,754.40 | Facility | None | $645.65 | $1,445.44 | $5,754.40 |
United Setting Professional Modifier None Typical Low $104.71 Median $154.88 Typical High $229.09 | Professional | None | $104.71 | $154.88 | $229.09 |
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 $70.79 Median $85.11 Typical High $107.15 | Professional | 52 · Reduced service | $70.79 | $85.11 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $33.88 Typical High $43.65 | Professional | 53 · Discontinued | $28.84 | $33.88 | $43.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $100.00 Median $117.49 Typical High $151.36 | Professional | 78 · Unplanned return to OR | $100.00 | $117.49 | $151.36 |
Where Rhode Island sits
The same service costs 3.4 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· 28th of 51
$182
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.