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 $158.49 Median $213.80 Typical High $302.00 | Professional | None | $158.49 | $213.80 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $165.96 Typical High $229.09 | Professional | 54 · Surgery only | $120.23 | $165.96 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $33.11 Typical High $45.71 | Professional | 55 · Aftercare only | $23.99 | $33.11 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $21.88 Typical High $30.20 | Professional | 56 · Pre-op care only | $15.85 | $21.88 | $30.20 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $162.18 Median $239.88 Typical High $316.23 | Professional | None | $162.18 | $239.88 | $316.23 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $91.20 Median $177.83 Typical High $251.19 | Professional | 54 · Surgery only | $91.20 | $177.83 | $251.19 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $22.39 Typical High $31.62 | Professional | 55 · Aftercare only | $11.48 | $22.39 | $31.62 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $22.39 Typical High $31.62 | Professional | 56 · Pre-op care only | $11.48 | $22.39 | $31.62 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $870.96 Typical High $1,071.52 | Facility | None | $588.84 | $870.96 | $1,071.52 |
Cigna Setting Professional Modifier None Typical Low $208.93 Median $269.15 Typical High $501.19 | Professional | None | $208.93 | $269.15 | $501.19 |
United Setting Facility Modifier None Typical Low $645.65 Median $1,445.44 Typical High $5,011.87 | Facility | None | $645.65 | $1,445.44 | $5,011.87 |
United Setting Professional Modifier None Typical Low $138.04 Median $239.88 Typical High $371.54 | Professional | None | $138.04 | $239.88 | $371.54 |
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 $79.43 Median $109.65 Typical High $151.36 | Professional | 52 · Reduced service | $79.43 | $109.65 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $43.65 Typical High $60.26 | Professional | 53 · Discontinued | $32.36 | $43.65 | $60.26 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $112.20 Median $154.88 Typical High $213.80 | Professional | 78 · Unplanned return to OR | $112.20 | $154.88 | $213.80 |
Where Rhode Island sits
The same service costs 4.7 times more in Alaska than in Virginia. 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· 26th of 51
$275
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.