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 $2,089.30 Median $2,754.23 Typical High $3,981.07 | Facility | None | $2,089.30 | $2,754.23 | $3,981.07 |
Aetna Setting Professional Modifier None Typical Low $389.05 Median $398.11 Typical High $436.52 | Professional | None | $389.05 | $398.11 | $436.52 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $302.00 Typical High $323.59 | Professional | 54 · Surgery only | $295.12 | $302.00 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $60.26 Typical High $64.57 | Professional | 55 · Aftercare only | $58.88 | $60.26 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $39.81 Typical High $43.65 | Professional | 56 · Pre-op care only | $38.90 | $39.81 | $43.65 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $354.81 Median $457.09 Typical High $660.69 | Professional | None | $354.81 | $457.09 | $660.69 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $295.12 Typical High $380.19 | Professional | 54 · Surgery only | $204.17 | $295.12 | $380.19 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $83.18 Typical High $107.15 | Professional | 55 · Aftercare only | $58.88 | $83.18 | $107.15 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $41.69 Typical High $53.70 | Professional | 56 · Pre-op care only | $29.51 | $41.69 | $53.70 |
Cigna Setting Facility Modifier None Typical Low $363.08 Median $489.78 Typical High $1,071.52 | Facility | None | $363.08 | $489.78 | $1,071.52 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $645.65 Typical High $707.95 | Professional | None | $398.11 | $645.65 | $707.95 |
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 $302.00 Median $338.84 Typical High $602.56 | Professional | None | $302.00 | $338.84 | $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 $194.98 Median $199.53 Typical High $218.78 | Professional | 52 · Reduced service | $194.98 | $199.53 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $79.43 Typical High $87.10 | Professional | 53 · Discontinued | $77.62 | $79.43 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $281.84 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $275.42 | $281.84 | $302.00 |
Where Rhode Island sits
The same service costs 5.6 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· 30th of 51
$437
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.