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 $141.25 Median $186.21 Typical High $208.93 | Professional | None | $141.25 | $186.21 | $208.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $141.25 Typical High $154.88 | Professional | 54 · Surgery only | $141.25 | $141.25 | $154.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $28.18 Typical High $30.90 | Professional | 55 · Aftercare only | $28.18 | $28.18 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $18.62 Typical High $20.89 | Professional | 56 · Pre-op care only | $18.62 | $18.62 | $20.89 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $120.23 Median $147.91 Typical High $257.04 | Professional | None | $120.23 | $147.91 | $257.04 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $102.33 Typical High $138.04 | Professional | 54 · Surgery only | $83.18 | $102.33 | $138.04 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $12.88 Typical High $16.98 | Professional | 55 · Aftercare only | $10.47 | $12.88 | $16.98 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $12.88 Typical High $16.98 | Professional | 56 · Pre-op care only | $10.47 | $12.88 | $16.98 |
Cigna Setting Facility Modifier None Typical Low $104.71 Median $141.25 Typical High $794.33 | Facility | None | $104.71 | $141.25 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $234.42 Typical High $269.15 | Professional | None | $199.53 | $234.42 | $269.15 |
United Setting Facility Modifier None Typical Low $97.72 Median $316.23 Typical High $3,890.45 | Facility | None | $97.72 | $316.23 | $3,890.45 |
United Setting Professional Modifier None Typical Low $100.00 Median $154.88 Typical High $239.88 | Professional | None | $100.00 | $154.88 | $239.88 |
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 $93.33 Median $93.33 Typical High $102.33 | Professional | 52 · Reduced service | $93.33 | $93.33 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $38.02 Typical High $41.69 | Professional | 53 · Discontinued | $38.02 | $38.02 | $41.69 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $131.83 Median $131.83 Typical High $144.54 | Professional | 78 · Unplanned return to OR | $131.83 | $131.83 | $144.54 |
Where Rhode Island sits
The same service costs 4.2 times more in Alaska than in Florida. 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· 20th of 51
$186
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.