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 $724.44 Median $724.44 Typical High $724.44 | Professional | None | $724.44 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $549.54 Typical High $549.54 | Professional | 54 · Surgery only | $549.54 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | 55 · Aftercare only | $109.65 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $72.44 Typical High $72.44 | Professional | 56 · Pre-op care only | $72.44 | $72.44 | $72.44 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $524.81 Median $691.83 Typical High $977.24 | Professional | None | $524.81 | $691.83 | $977.24 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $407.38 Typical High $478.63 | Professional | 54 · Surgery only | $338.84 | $407.38 | $478.63 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $123.03 Typical High $144.54 | Professional | 55 · Aftercare only | $102.33 | $123.03 | $144.54 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $58.88 Typical High $69.18 | Professional | 56 · Pre-op care only | $48.98 | $58.88 | $69.18 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $2,137.96 Typical High $3,090.30 | Facility | None | $676.08 | $2,137.96 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $794.33 Median $1,023.29 Typical High $1,071.52 | Professional | None | $794.33 | $1,023.29 | $1,071.52 |
United Setting Facility Modifier None Typical Low $870.96 Median $2,089.30 Typical High $7,244.36 | Facility | None | $870.96 | $2,089.30 | $7,244.36 |
United Setting Professional Modifier None Typical Low $467.74 Median $616.60 Typical High $1,071.52 | Professional | None | $467.74 | $616.60 | $1,071.52 |
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 $363.08 Median $363.08 Typical High $363.08 | Professional | 52 · Reduced service | $363.08 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $147.91 Typical High $147.91 | Professional | 53 · Discontinued | $147.91 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $512.86 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $512.86 | $512.86 | $512.86 |
Where Rhode Island sits
The same service costs 8.9 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· 32nd of 51
$724
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.