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 $229.09 Median $251.19 Typical High $338.84 | Professional | None | $229.09 | $251.19 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $181.97 Typical High $257.04 | Professional | 54 · Surgery only | $169.82 | $181.97 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $36.31 Typical High $51.29 | Professional | 55 · Aftercare only | $33.88 | $36.31 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $24.55 Typical High $33.88 | Professional | 56 · Pre-op care only | $22.91 | $24.55 | $33.88 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $186.21 Median $288.40 Typical High $338.84 | Professional | None | $186.21 | $288.40 | $338.84 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $173.78 Typical High $269.15 | Professional | 54 · Surgery only | $123.03 | $173.78 | $269.15 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $21.88 Typical High $33.88 | Professional | 55 · Aftercare only | $15.14 | $21.88 | $33.88 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $21.88 Typical High $33.88 | Professional | 56 · Pre-op care only | $15.14 | $21.88 | $33.88 |
Cigna Setting Facility Modifier None Typical Low $218.78 Median $302.00 Typical High $1,071.52 | Facility | None | $218.78 | $302.00 | $1,071.52 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $331.13 Typical High $436.52 | Professional | None | $269.15 | $331.13 | $436.52 |
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 $162.18 Median $234.42 Typical High $346.74 | Professional | None | $162.18 | $234.42 | $346.74 |
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 $114.82 Median $123.03 Typical High $169.82 | Professional | 52 · Reduced service | $114.82 | $123.03 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $48.98 Typical High $67.61 | Professional | 53 · Discontinued | $45.71 | $48.98 | $67.61 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $158.49 Median $169.82 Typical High $239.88 | Professional | 78 · Unplanned return to OR | $158.49 | $169.82 | $239.88 |
Where Rhode Island sits
The same service costs 3.6 times more in Alaska 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· 26th of 51
$269
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.