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 $239.88 Median $251.19 Typical High $269.15 | Professional | None | $239.88 | $251.19 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $177.83 Typical High $199.53 | Professional | 54 · Surgery only | $177.83 | $177.83 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $35.48 Typical High $39.81 | Professional | 55 · Aftercare only | $35.48 | $35.48 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $23.99 Typical High $26.92 | Professional | 56 · Pre-op care only | $23.99 | $23.99 | $26.92 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $194.98 Median $257.04 Typical High $363.08 | Professional | None | $194.98 | $257.04 | $363.08 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $186.21 Typical High $275.42 | Professional | 54 · Surgery only | $128.82 | $186.21 | $275.42 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $22.91 Typical High $33.88 | Professional | 55 · Aftercare only | $16.22 | $22.91 | $33.88 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $22.91 Typical High $33.88 | Professional | 56 · Pre-op care only | $16.22 | $22.91 | $33.88 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $2,238.72 Typical High $3,235.94 | Facility | None | $446.68 | $2,238.72 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $263.03 Median $331.13 Typical High $446.68 | Professional | None | $263.03 | $331.13 | $446.68 |
United Setting Facility Modifier None Typical Low $870.96 Median $2,089.30 Typical High $7,079.46 | Facility | None | $870.96 | $2,089.30 | $7,079.46 |
United Setting Professional Modifier None Typical Low $190.55 Median $239.88 Typical High $363.08 | Professional | None | $190.55 | $239.88 | $363.08 |
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 $120.23 Median $120.23 Typical High $134.90 | Professional | 52 · Reduced service | $120.23 | $120.23 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $47.86 Typical High $53.70 | Professional | 53 · Discontinued | $47.86 | $47.86 | $53.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $165.96 Typical High $186.21 | Professional | 78 · Unplanned return to OR | $165.96 | $165.96 | $186.21 |
Where Rhode Island sits
The same service costs 4.4 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· 32nd 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.