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 $776.25 Median $776.25 Typical High $776.25 | Professional | None | $776.25 | $776.25 | $776.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $588.84 Typical High $588.84 | Professional | 54 · Surgery only | $588.84 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $117.49 Typical High $117.49 | Professional | 55 · Aftercare only | $117.49 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $77.62 Typical High $77.62 | Professional | 56 · Pre-op care only | $77.62 | $77.62 | $77.62 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $549.54 Median $741.31 Typical High $1,023.29 | Professional | None | $549.54 | $741.31 | $1,023.29 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $436.52 Typical High $512.86 | Professional | 54 · Surgery only | $354.81 | $436.52 | $512.86 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $131.83 Typical High $154.88 | Professional | 55 · Aftercare only | $107.15 | $131.83 | $154.88 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $63.10 Typical High $74.13 | Professional | 56 · Pre-op care only | $51.29 | $63.10 | $74.13 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $4,786.30 Typical High $6,918.31 | Facility | None | $676.08 | $4,786.30 | $6,918.31 |
Cigna Setting Professional Modifier None Typical Low $870.96 Median $1,096.48 Typical High $1,230.27 | Professional | None | $870.96 | $1,096.48 | $1,230.27 |
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 $501.19 Median $676.08 Typical High $1,122.02 | Professional | None | $501.19 | $676.08 | $1,122.02 |
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 $389.05 Median $389.05 Typical High $389.05 | Professional | 52 · Reduced service | $389.05 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $158.49 Typical High $158.49 | Professional | 53 · Discontinued | $158.49 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $549.54 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $549.54 | $549.54 | $549.54 |
Where Rhode Island sits
The same service costs 8.1 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
$776
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.