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 $676.08 Median $707.95 Typical High $851.14 | Professional | None | $676.08 | $707.95 | $851.14 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $537.03 Typical High $630.96 | Professional | 54 · Surgery only | $537.03 | $537.03 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $107.15 Typical High $125.89 | Professional | 55 · Aftercare only | $107.15 | $107.15 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $70.79 Typical High $85.11 | Professional | 56 · Pre-op care only | $70.79 | $70.79 | $85.11 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $575.44 Median $691.83 Typical High $1,174.90 | Professional | None | $575.44 | $691.83 | $1,174.90 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $436.52 Typical High $758.58 | Professional | 54 · Surgery only | $338.84 | $436.52 | $758.58 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $117.49 Typical High $199.53 | Professional | 55 · Aftercare only | $91.20 | $117.49 | $199.53 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $61.66 Typical High $104.71 | Professional | 56 · Pre-op care only | $47.86 | $61.66 | $104.71 |
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 $1,659.59 | Professional | None | $616.60 | $741.31 | $1,659.59 |
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 $562.34 Median $831.76 Typical High $1,412.54 | Professional | None | $562.34 | $831.76 | $1,412.54 |
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 $354.81 Median $354.81 Typical High $426.58 | Professional | 52 · Reduced service | $354.81 | $354.81 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $141.25 Typical High $169.82 | Professional | 53 · Discontinued | $141.25 | $141.25 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $501.19 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $501.19 | $501.19 | $588.84 |
Where Rhode Island sits
The same service costs 4.5 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· 30th of 51
$832
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.