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 $1,513.56 Median $1,548.82 Typical High $3,981.07 | Facility | None | $1,513.56 | $1,548.82 | $3,981.07 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $616.60 | Professional | None | $616.60 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $457.09 Typical High $457.09 | Professional | 54 · Surgery only | $457.09 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $91.20 Typical High $91.20 | Professional | 55 · Aftercare only | $91.20 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | 56 · Pre-op care only | $61.66 | $61.66 | $61.66 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $457.09 Median $602.56 Typical High $831.76 | Professional | None | $457.09 | $602.56 | $831.76 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $354.81 Typical High $416.87 | Professional | 54 · Surgery only | $295.12 | $354.81 | $416.87 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $107.15 Typical High $128.82 | Professional | 55 · Aftercare only | $89.13 | $107.15 | $128.82 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $51.29 Typical High $60.26 | Professional | 56 · Pre-op care only | $42.66 | $51.29 | $60.26 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $1,148.15 Typical High $1,621.81 | Facility | None | $446.68 | $1,148.15 | $1,621.81 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $891.25 Typical High $977.24 | Professional | None | $676.08 | $891.25 | $977.24 |
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 $398.11 Median $512.86 Typical High $912.01 | Professional | None | $398.11 | $512.86 | $912.01 |
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 $309.03 Median $309.03 Typical High $309.03 | Professional | 52 · Reduced service | $309.03 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $123.03 Typical High $123.03 | Professional | 53 · Discontinued | $123.03 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $426.58 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $426.58 | $426.58 | $426.58 |
Where Rhode Island sits
The same service costs 7.6 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· 31st of 51
$617
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.