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 $407.38 Typical High $489.78 | Professional | None | $302.00 | $407.38 | $489.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $309.03 Typical High $371.54 | Professional | 54 · Surgery only | $229.09 | $309.03 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $61.66 Typical High $74.13 | Professional | 55 · Aftercare only | $45.71 | $61.66 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $40.74 Typical High $48.98 | Professional | 56 · Pre-op care only | $30.20 | $40.74 | $48.98 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $302.00 Median $436.52 Typical High $537.03 | Professional | None | $302.00 | $436.52 | $537.03 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $288.40 Typical High $407.38 | Professional | 54 · Surgery only | $169.82 | $288.40 | $407.38 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $35.48 Typical High $51.29 | Professional | 55 · Aftercare only | $20.89 | $35.48 | $51.29 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $35.48 Typical High $51.29 | Professional | 56 · Pre-op care only | $20.89 | $35.48 | $51.29 |
Cigna Setting Facility Modifier None Typical Low $208.93 Median $281.84 Typical High $1,202.26 | Facility | None | $208.93 | $281.84 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $380.19 Median $457.09 Typical High $812.83 | Professional | None | $380.19 | $457.09 | $812.83 |
United Setting Facility Modifier None Typical Low $97.72 Median $316.23 Typical High $3,890.45 | Facility | None | $97.72 | $316.23 | $3,890.45 |
United Setting Professional Modifier None Typical Low $263.03 Median $398.11 Typical High $602.56 | Professional | None | $263.03 | $398.11 | $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 $151.36 Median $204.17 Typical High $245.47 | Professional | 52 · Reduced service | $151.36 | $204.17 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $83.18 Typical High $97.72 | Professional | 53 · Discontinued | $60.26 | $83.18 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $213.80 Median $288.40 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $213.80 | $288.40 | $346.74 |
Where Rhode Island sits
The same service costs 3.4 times more in Alaska than in Maryland. 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· 17th of 51
$457
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.