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 $660.69 Median $776.25 Typical High $1,047.13 | Professional | None | $660.69 | $776.25 | $1,047.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $537.03 Typical High $616.60 | Professional | 54 · Surgery only | $537.03 | $537.03 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $109.65 Typical High $123.03 | Professional | 55 · Aftercare only | $109.65 | $109.65 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $72.44 Typical High $81.28 | Professional | 56 · Pre-op care only | $72.44 | $72.44 | $81.28 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $588.84 Median $691.83 Typical High $1,174.90 | Professional | None | $588.84 | $691.83 | $1,174.90 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $426.58 Typical High $724.44 | Professional | 54 · Surgery only | $338.84 | $426.58 | $724.44 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $114.82 Typical High $194.98 | Professional | 55 · Aftercare only | $91.20 | $114.82 | $194.98 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $60.26 Typical High $102.33 | Professional | 56 · Pre-op care only | $47.86 | $60.26 | $102.33 |
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 $616.60 Median $741.31 Typical High $1,621.81 | Professional | None | $616.60 | $741.31 | $1,621.81 |
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 $575.44 Median $812.83 Typical High $1,348.96 | Professional | None | $575.44 | $812.83 | $1,348.96 |
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 $363.08 Median $363.08 Typical High $407.38 | Professional | 52 · Reduced service | $363.08 | $363.08 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $144.54 Typical High $165.96 | Professional | 53 · Discontinued | $144.54 | $144.54 | $165.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $501.19 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $501.19 | $501.19 | $575.44 |
Where Rhode Island sits
The same service costs 4.6 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
$813
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.