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 $3,019.95 Median $3,715.35 Typical High $3,981.07 | Facility | None | $3,019.95 | $3,715.35 | $3,981.07 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | None | $229.09 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | 54 · Surgery only | $173.78 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $34.67 Typical High $34.67 | Professional | 55 · Aftercare only | $34.67 | $34.67 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $22.91 Typical High $22.91 | Professional | 56 · Pre-op care only | $22.91 | $22.91 | $22.91 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $229.09 Median $269.15 Typical High $269.15 | Professional | None | $229.09 | $269.15 | $269.15 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $186.21 Typical High $218.78 | Professional | 54 · Surgery only | $131.83 | $186.21 | $218.78 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $22.91 Typical High $26.92 | Professional | 55 · Aftercare only | $16.22 | $22.91 | $26.92 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $20.89 Typical High $24.55 | Professional | 56 · Pre-op care only | $14.45 | $20.89 | $24.55 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $1,949.84 Typical High $2,754.23 | Facility | None | $831.76 | $1,949.84 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $323.59 Typical High $323.59 | Professional | None | $281.84 | $323.59 | $323.59 |
United Setting Facility Modifier None Typical Low $870.96 Median $2,089.30 Typical High $7,413.10 | Facility | None | $870.96 | $2,089.30 | $7,413.10 |
United Setting Professional Modifier None Typical Low $173.78 Median $194.98 Typical High $288.40 | Professional | None | $173.78 | $194.98 | $288.40 |
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 $114.82 Typical High $114.82 | Professional | 52 · Reduced service | $114.82 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $45.71 Typical High $45.71 | Professional | 53 · Discontinued | $45.71 | $45.71 | $45.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | 78 · Unplanned return to OR | $162.18 | $162.18 | $162.18 |
Where Rhode Island sits
The same service costs 5.9 times more in Alaska 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· 28th of 51
$245
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.