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 $3,715.35 Typical High $3,981.07 | Facility | None | $3,715.35 | $3,715.35 | $3,981.07 |
Aetna Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $831.76 | Professional | None | $831.76 | $831.76 | $831.76 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $630.96 Typical High $630.96 | Professional | 54 · Surgery only | $630.96 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | 55 · Aftercare only | $125.89 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | 56 · Pre-op care only | $83.18 | $83.18 | $83.18 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $645.65 Median $870.96 Typical High $1,174.90 | Professional | None | $645.65 | $870.96 | $1,174.90 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $501.19 Typical High $588.84 | Professional | 54 · Surgery only | $416.87 | $501.19 | $588.84 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $154.88 Typical High $181.97 | Professional | 55 · Aftercare only | $125.89 | $154.88 | $181.97 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $72.44 Typical High $87.10 | Professional | 56 · Pre-op care only | $60.26 | $72.44 | $87.10 |
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 $1,000.00 Median $1,288.25 Typical High $1,380.38 | Professional | None | $1,000.00 | $1,288.25 | $1,380.38 |
United Setting Facility Modifier None Typical Low $1,023.29 Median $4,570.88 Typical High $10,471.29 | Facility | None | $1,023.29 | $4,570.88 | $10,471.29 |
United Setting Professional Modifier None Typical Low $575.44 Median $724.44 Typical High $1,288.25 | Professional | None | $575.44 | $724.44 | $1,288.25 |
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 $416.87 | Professional | 52 · Reduced service | $416.87 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | 53 · Discontinued | $165.96 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $588.84 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $588.84 | $588.84 | $588.84 |
Where Rhode Island sits
The same service costs 19.5 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· 29th 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.