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 $2,398.83 Median $3,235.94 Typical High $3,981.07 | Facility | None | $2,398.83 | $3,235.94 | $3,981.07 |
Aetna Setting Professional Modifier None Typical Low $288.40 Median $302.00 Typical High $389.05 | Professional | None | $288.40 | $302.00 | $389.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $229.09 Typical High $295.12 | Professional | 54 · Surgery only | $213.80 | $229.09 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $45.71 Typical High $58.88 | Professional | 55 · Aftercare only | $42.66 | $45.71 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $30.20 Typical High $38.90 | Professional | 56 · Pre-op care only | $28.84 | $30.20 | $38.90 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $239.88 Median $316.23 Typical High $398.11 | Professional | None | $239.88 | $316.23 | $398.11 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $181.97 Typical High $257.04 | Professional | 54 · Surgery only | $117.49 | $181.97 | $257.04 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $51.29 Typical High $74.13 | Professional | 55 · Aftercare only | $33.11 | $51.29 | $74.13 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $25.70 Typical High $37.15 | Professional | 56 · Pre-op care only | $16.60 | $25.70 | $37.15 |
Cigna Setting Facility Modifier None Typical Low $295.12 Median $398.11 Typical High $794.33 | Facility | None | $295.12 | $398.11 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $363.08 Typical High $588.84 | Professional | None | $295.12 | $363.08 | $588.84 |
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 $199.53 Median $309.03 Typical High $446.68 | Professional | None | $199.53 | $309.03 | $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 $144.54 Median $151.36 Typical High $194.98 | Professional | 52 · Reduced service | $144.54 | $151.36 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $60.26 Typical High $77.62 | Professional | 53 · Discontinued | $57.54 | $60.26 | $77.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $199.53 Median $213.80 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $199.53 | $213.80 | $275.42 |
Where Rhode Island sits
The same service costs 4.3 times more in Wyoming 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· 21st of 51
$363
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.