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 $302.00 Median $316.23 Typical High $371.54 | Professional | None | $302.00 | $316.23 | $371.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $223.87 Median $234.42 Typical High $281.84 | Professional | 54 · Surgery only | $223.87 | $234.42 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $47.86 Typical High $56.23 | Professional | 55 · Aftercare only | $45.71 | $47.86 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $31.62 Typical High $37.15 | Professional | 56 · Pre-op care only | $30.20 | $31.62 | $37.15 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $263.03 Median $354.81 Typical High $478.63 | Professional | None | $263.03 | $354.81 | $478.63 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $223.87 Typical High $288.40 | Professional | 54 · Surgery only | $154.88 | $223.87 | $288.40 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $27.54 Typical High $36.31 | Professional | 55 · Aftercare only | $19.50 | $27.54 | $36.31 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $27.54 Typical High $36.31 | Professional | 56 · Pre-op care only | $19.50 | $27.54 | $36.31 |
Cigna Setting Facility Modifier None Typical Low $234.42 Median $316.23 Typical High $794.33 | Facility | None | $234.42 | $316.23 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $346.74 Median $426.58 Typical High $549.54 | Professional | None | $346.74 | $426.58 | $549.54 |
United Setting Facility Modifier None Typical Low $371.54 Median $1,096.48 Typical High $4,265.80 | Facility | None | $371.54 | $1,096.48 | $4,265.80 |
United Setting Professional Modifier None Typical Low $239.88 Median $371.54 Typical High $446.68 | Professional | None | $239.88 | $371.54 | $446.68 |
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 $151.36 Median $158.49 Typical High $186.21 | Professional | 52 · Reduced service | $151.36 | $158.49 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $63.10 Typical High $74.13 | Professional | 53 · Discontinued | $60.26 | $63.10 | $74.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $208.93 Median $218.78 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $208.93 | $218.78 | $263.03 |
Where Rhode Island sits
The same service costs 4.2 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
$372
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.