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 $158.49 Median $169.82 Typical High $177.83 | Professional | None | $158.49 | $169.82 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $128.82 Typical High $131.83 | Professional | 54 · Surgery only | $117.49 | $128.82 | $131.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $25.70 Typical High $26.30 | Professional | 55 · Aftercare only | $23.44 | $25.70 | $26.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $16.98 Typical High $17.78 | Professional | 56 · Pre-op care only | $15.85 | $16.98 | $17.78 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $151.36 Median $190.55 Typical High $269.15 | Professional | None | $151.36 | $190.55 | $269.15 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $100.00 Median $141.25 Typical High $181.97 | Professional | 54 · Surgery only | $100.00 | $141.25 | $181.97 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $17.78 Typical High $22.91 | Professional | 55 · Aftercare only | $12.59 | $17.78 | $22.91 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $17.78 Typical High $22.91 | Professional | 56 · Pre-op care only | $12.59 | $17.78 | $22.91 |
Cigna Setting Facility Modifier None Typical Low $112.20 Median $151.36 Typical High $794.33 | Facility | None | $112.20 | $151.36 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $269.15 Typical High $281.84 | Professional | None | $158.49 | $269.15 | $281.84 |
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 $109.65 Median $173.78 Typical High $288.40 | Professional | None | $109.65 | $173.78 | $288.40 |
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 $85.11 Typical High $89.13 | Professional | 52 · Reduced service | $79.43 | $85.11 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $33.88 Typical High $35.48 | Professional | 53 · Discontinued | $31.62 | $33.88 | $35.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $109.65 Median $120.23 Typical High $123.03 | Professional | 78 · Unplanned return to OR | $109.65 | $120.23 | $123.03 |
Where Rhode Island sits
The same service costs 4.6 times more in Alaska than in Florida. 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
$191
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.