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 $275.42 Median $275.42 Typical High $275.42 | Professional | None | $275.42 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $208.93 Typical High $208.93 | Professional | 54 · Surgery only | $208.93 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $41.69 Typical High $41.69 | Professional | 55 · Aftercare only | $41.69 | $41.69 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $27.54 Typical High $27.54 | Professional | 56 · Pre-op care only | $27.54 | $27.54 | $27.54 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $316.23 Median $371.54 Typical High $371.54 | Professional | None | $316.23 | $371.54 | $371.54 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $257.04 Typical High $302.00 | Professional | 54 · Surgery only | $177.83 | $257.04 | $302.00 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $31.62 Typical High $37.15 | Professional | 55 · Aftercare only | $21.88 | $31.62 | $37.15 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $28.18 Typical High $33.11 | Professional | 56 · Pre-op care only | $19.95 | $28.18 | $33.11 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $1,862.09 Typical High $2,691.53 | Facility | None | $676.08 | $1,862.09 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $457.09 | Professional | None | $457.09 | $457.09 | $457.09 |
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 $194.98 Median $257.04 Typical High $380.19 | Professional | None | $194.98 | $257.04 | $380.19 |
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 $138.04 Median $138.04 Typical High $138.04 | Professional | 52 · Reduced service | $138.04 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $56.23 Typical High $56.23 | Professional | 53 · Discontinued | $56.23 | $56.23 | $56.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $194.98 Typical High $194.98 | Professional | 78 · Unplanned return to OR | $194.98 | $194.98 | $194.98 |
Where Rhode Island sits
The same service costs 5.2 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· 28th of 51
$331
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.