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 $3,715.35 Median $3,981.07 Typical High $5,495.41 | Facility | None | $3,715.35 | $3,981.07 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $1,000.00 | Professional | None | $851.14 | $851.14 | $1,000.00 |
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 $537.03 Median $645.65 Typical High $1,288.25 | Professional | None | $537.03 | $645.65 | $1,288.25 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $398.11 Typical High $524.81 | Professional | 54 · Surgery only | $309.03 | $398.11 | $524.81 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $120.23 Typical High $162.18 | Professional | 55 · Aftercare only | $95.50 | $120.23 | $162.18 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $57.54 Typical High $75.86 | Professional | 56 · Pre-op care only | $44.67 | $57.54 | $75.86 |
Cigna Setting Facility Modifier None Typical Low $1,318.26 Median $2,818.38 Typical High $3,981.07 | Facility | None | $1,318.26 | $2,818.38 | $3,981.07 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $1,047.13 Typical High $1,122.02 | Professional | None | $933.25 | $1,047.13 | $1,122.02 |
United Setting Facility Modifier None Typical Low $870.96 Median $2,089.30 Typical High $7,413.10 | Facility | None | $870.96 | $2,089.30 | $7,413.10 |
United Setting Professional Modifier None Typical Low $489.78 Median $741.31 Typical High $1,202.26 | Professional | None | $489.78 | $741.31 | $1,202.26 |
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 6.2 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· 24th of 51
$851
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.