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 $758.58 Median $851.14 Typical High $891.25 | Professional | None | $758.58 | $851.14 | $891.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $645.65 Typical High $676.08 | Professional | 54 · Surgery only | $575.44 | $645.65 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $128.82 Typical High $134.90 | Professional | 55 · Aftercare only | $114.82 | $128.82 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $85.11 Typical High $89.13 | Professional | 56 · Pre-op care only | $75.86 | $85.11 | $89.13 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $602.56 Median $724.44 Typical High $1,258.93 | Professional | None | $602.56 | $724.44 | $1,258.93 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $436.52 Typical High $588.84 | Professional | 54 · Surgery only | $338.84 | $436.52 | $588.84 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $134.90 Typical High $177.83 | Professional | 55 · Aftercare only | $104.71 | $134.90 | $177.83 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $64.57 Typical High $85.11 | Professional | 56 · Pre-op care only | $50.12 | $64.57 | $85.11 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $954.99 Typical High $1,230.27 | Facility | None | $588.84 | $954.99 | $1,230.27 |
Cigna Setting Professional Modifier None Typical Low $891.25 Median $1,071.52 Typical High $1,288.25 | Professional | None | $891.25 | $1,071.52 | $1,288.25 |
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 $478.63 Median $616.60 Typical High $1,230.27 | Professional | None | $478.63 | $616.60 | $1,230.27 |
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 $380.19 Median $426.58 Typical High $446.68 | Professional | 52 · Reduced service | $380.19 | $426.58 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $169.82 Typical High $177.83 | Professional | 53 · Discontinued | $151.36 | $169.82 | $177.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $602.56 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $537.03 | $602.56 | $630.96 |
Where Rhode Island sits
The same service costs 5.6 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· 20th 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.