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 $269.15 Median $323.59 Typical High $380.19 | Professional | None | $269.15 | $323.59 | $380.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $239.88 Typical High $288.40 | Professional | 54 · Surgery only | $204.17 | $239.88 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $47.86 Typical High $57.54 | Professional | 55 · Aftercare only | $40.74 | $47.86 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $32.36 Typical High $38.02 | Professional | 56 · Pre-op care only | $26.92 | $32.36 | $38.02 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $257.04 Median $380.19 Typical High $478.63 | Professional | None | $257.04 | $380.19 | $478.63 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $239.88 Typical High $380.19 | Professional | 54 · Surgery only | $169.82 | $239.88 | $380.19 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $30.20 Typical High $47.86 | Professional | 55 · Aftercare only | $20.89 | $30.20 | $47.86 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $30.20 Typical High $47.86 | Professional | 56 · Pre-op care only | $20.89 | $30.20 | $47.86 |
Cigna Setting Facility Modifier None Typical Low $309.03 Median $426.58 Typical High $1,202.26 | Facility | None | $309.03 | $426.58 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $467.74 Typical High $588.84 | Professional | None | $363.08 | $467.74 | $588.84 |
United Setting Facility Modifier None Typical Low $645.65 Median $1,445.44 Typical High $5,011.87 | Facility | None | $645.65 | $1,445.44 | $5,011.87 |
United Setting Professional Modifier None Typical Low $204.17 Median $288.40 Typical High $446.68 | Professional | None | $204.17 | $288.40 | $446.68 |
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 $134.90 Median $158.49 Typical High $190.55 | Professional | 52 · Reduced service | $134.90 | $158.49 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $64.57 Typical High $75.86 | Professional | 53 · Discontinued | $53.70 | $64.57 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $223.87 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $190.55 | $223.87 | $269.15 |
Where Rhode Island sits
The same service costs 3.6 times more in Alaska than in New Jersey. 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· 27th of 51
$363
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.