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 $2,089.30 Median $2,754.23 Typical High $3,981.07 | Facility | None | $2,089.30 | $2,754.23 | $3,981.07 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $616.60 Typical High $851.14 | Professional | None | $489.78 | $616.60 | $851.14 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $457.09 Typical High $645.65 | Professional | 54 · Surgery only | $363.08 | $457.09 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $91.20 Typical High $128.82 | Professional | 55 · Aftercare only | $72.44 | $91.20 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $61.66 Typical High $85.11 | Professional | 56 · Pre-op care only | $48.98 | $61.66 | $85.11 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $371.54 Median $575.44 Typical High $870.96 | Professional | None | $371.54 | $575.44 | $870.96 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $363.08 Typical High $512.86 | Professional | 54 · Surgery only | $208.93 | $363.08 | $512.86 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $109.65 Typical High $158.49 | Professional | 55 · Aftercare only | $64.57 | $109.65 | $158.49 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $52.48 Typical High $74.13 | Professional | 56 · Pre-op care only | $30.90 | $52.48 | $74.13 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $3,981.07 Typical High $5,623.41 | Facility | None | $588.84 | $3,981.07 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $630.96 Median $851.14 Typical High $1,122.02 | Professional | None | $630.96 | $851.14 | $1,122.02 |
United Setting Facility Modifier None Typical Low $933.25 Median $3,548.13 Typical High $12,589.25 | Facility | None | $933.25 | $3,548.13 | $12,589.25 |
United Setting Professional Modifier None Typical Low $323.59 Median $575.44 Typical High $1,122.02 | Professional | None | $323.59 | $575.44 | $1,122.02 |
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 $239.88 Median $309.03 Typical High $426.58 | Professional | 52 · Reduced service | $239.88 | $309.03 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $123.03 Typical High $173.78 | Professional | 53 · Discontinued | $97.72 | $123.03 | $173.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $426.58 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $338.84 | $426.58 | $602.56 |
Where Rhode Island sits
The same service costs 4.9 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
$631
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.