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 $389.05 Median $389.05 Typical High $446.68 | Professional | None | $389.05 | $389.05 | $446.68 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $302.00 Typical High $331.13 | Professional | 54 · Surgery only | $288.40 | $302.00 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $60.26 Typical High $66.07 | Professional | 55 · Aftercare only | $57.54 | $60.26 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $39.81 Typical High $44.67 | Professional | 56 · Pre-op care only | $38.90 | $39.81 | $44.67 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $389.05 Median $512.86 Typical High $676.08 | Professional | None | $389.05 | $512.86 | $676.08 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $281.84 Typical High $363.08 | Professional | 54 · Surgery only | $199.53 | $281.84 | $363.08 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $81.28 Typical High $104.71 | Professional | 55 · Aftercare only | $57.54 | $81.28 | $104.71 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $40.74 Typical High $52.48 | Professional | 56 · Pre-op care only | $28.18 | $40.74 | $52.48 |
Cigna Setting Facility Modifier None Typical Low $354.81 Median $478.63 Typical High $1,202.26 | Facility | None | $354.81 | $478.63 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $616.60 Typical High $812.83 | Professional | None | $398.11 | $616.60 | $812.83 |
United Setting Facility Modifier None Typical Low $870.96 Median $2,089.30 Typical High $5,888.44 | Facility | None | $870.96 | $2,089.30 | $5,888.44 |
United Setting Professional Modifier None Typical Low $263.03 Median $363.08 Typical High $602.56 | Professional | None | $263.03 | $363.08 | $602.56 |
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 $190.55 Median $199.53 Typical High $218.78 | Professional | 52 · Reduced service | $190.55 | $199.53 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $79.43 Typical High $89.13 | Professional | 53 · Discontinued | $77.62 | $79.43 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $269.15 Median $281.84 Typical High $309.03 | Professional | 78 · Unplanned return to OR | $269.15 | $281.84 | $309.03 |
Where Rhode Island sits
The same service costs 5.0 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
$447
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.