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 $794.33 Median $933.25 Typical High $1,348.96 | Professional | None | $794.33 | $933.25 | $1,348.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $630.96 Typical High $758.58 | Professional | 54 · Surgery only | $630.96 | $630.96 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $125.89 Typical High $151.36 | Professional | 55 · Aftercare only | $125.89 | $125.89 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $85.11 Typical High $100.00 | Professional | 56 · Pre-op care only | $85.11 | $85.11 | $100.00 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $676.08 Median $831.76 Typical High $1,380.38 | Professional | None | $676.08 | $831.76 | $1,380.38 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $512.86 Typical High $870.96 | Professional | 54 · Surgery only | $398.11 | $512.86 | $870.96 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $138.04 Typical High $234.42 | Professional | 55 · Aftercare only | $107.15 | $138.04 | $234.42 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $72.44 Typical High $123.03 | Professional | 56 · Pre-op care only | $56.23 | $72.44 | $123.03 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $1,479.11 Typical High $2,089.30 | Facility | None | $676.08 | $1,479.11 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $707.95 Median $870.96 Typical High $1,949.84 | Professional | None | $707.95 | $870.96 | $1,949.84 |
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 $676.08 Median $977.24 Typical High $1,659.59 | Professional | None | $676.08 | $977.24 | $1,659.59 |
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 $416.87 Median $416.87 Typical High $501.19 | Professional | 52 · Reduced service | $416.87 | $416.87 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $169.82 Typical High $199.53 | Professional | 53 · Discontinued | $169.82 | $169.82 | $199.53 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $588.84 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $588.84 | $588.84 | $707.95 |
Where Rhode Island sits
The same service costs 4.4 times more in Alaska than in Texas. 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· 31st of 51
$977
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.