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 $2,089.30 Median $2,754.23 Typical High $3,981.07 | Facility | None | $2,089.30 | $2,754.23 | $3,981.07 |
Aetna Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $977.24 | Professional | None | $977.24 | $977.24 | $977.24 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $724.44 Typical High $724.44 | Professional | 54 · Surgery only | $724.44 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | 55 · Aftercare only | $144.54 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $97.72 Typical High $97.72 | Professional | 56 · Pre-op care only | $97.72 | $97.72 | $97.72 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $741.31 Median $977.24 Typical High $1,348.96 | Professional | None | $741.31 | $977.24 | $1,348.96 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $575.44 Typical High $676.08 | Professional | 54 · Surgery only | $478.63 | $575.44 | $676.08 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $177.83 Typical High $208.93 | Professional | 55 · Aftercare only | $144.54 | $177.83 | $208.93 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $83.18 Typical High $97.72 | Professional | 56 · Pre-op care only | $69.18 | $83.18 | $97.72 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $2,137.96 Typical High $3,090.30 | Facility | None | $588.84 | $2,137.96 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $1,096.48 Median $1,479.11 Typical High $1,548.82 | Professional | None | $1,096.48 | $1,479.11 | $1,548.82 |
United Setting Facility Modifier None Typical Low $645.65 Median $1,445.44 Typical High $5,754.40 | Facility | None | $645.65 | $1,445.44 | $5,754.40 |
United Setting Professional Modifier None Typical Low $645.65 Median $812.83 Typical High $1,445.44 | Professional | None | $645.65 | $812.83 | $1,445.44 |
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 $478.63 Median $478.63 Typical High $478.63 | Professional | 52 · Reduced service | $478.63 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $194.98 Typical High $194.98 | Professional | 53 · Discontinued | $194.98 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $676.08 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $676.08 | $676.08 | $676.08 |
Where Rhode Island sits
The same service costs 8.3 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
$977
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.