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 $3,467.37 Median $3,715.35 Typical High $3,981.07 | Facility | None | $3,467.37 | $3,715.35 | $3,981.07 |
Aetna Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $870.96 | Professional | None | $870.96 | $870.96 | $870.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $660.69 Typical High $660.69 | Professional | 54 · Surgery only | $660.69 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $131.83 Typical High $131.83 | Professional | 55 · Aftercare only | $131.83 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $87.10 Typical High $87.10 | Professional | 56 · Pre-op care only | $87.10 | $87.10 | $87.10 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $616.60 Median $831.76 Typical High $1,148.15 | Professional | None | $616.60 | $831.76 | $1,148.15 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $478.63 Typical High $575.44 | Professional | 54 · Surgery only | $398.11 | $478.63 | $575.44 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $147.91 Typical High $173.78 | Professional | 55 · Aftercare only | $120.23 | $147.91 | $173.78 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $70.79 Typical High $83.18 | Professional | 56 · Pre-op care only | $57.54 | $70.79 | $83.18 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $4,786.30 Typical High $6,918.31 | Facility | None | $954.99 | $4,786.30 | $6,918.31 |
Cigna Setting Professional Modifier None Typical Low $977.24 Median $1,202.26 Typical High $1,380.38 | Professional | None | $977.24 | $1,202.26 | $1,380.38 |
United Setting Facility Modifier None Typical Low $812.83 Median $2,630.27 Typical High $9,549.93 | Facility | None | $812.83 | $2,630.27 | $9,549.93 |
United Setting Professional Modifier None Typical Low $562.34 Median $758.58 Typical High $1,258.93 | Professional | None | $562.34 | $758.58 | $1,258.93 |
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 $436.52 Median $436.52 Typical High $436.52 | Professional | 52 · Reduced service | $436.52 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $177.83 Typical High $177.83 | Professional | 53 · Discontinued | $177.83 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $616.60 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $616.60 | $616.60 | $616.60 |
Where Rhode Island sits
The same service costs 7.8 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
$871
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.