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 $870.96 Median $870.96 Typical High $870.96 | Professional | None | $870.96 | $870.96 | $870.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $645.65 Typical High $645.65 | Professional | 54 · Surgery only | $645.65 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $128.82 Typical High $128.82 | Professional | 55 · Aftercare only | $128.82 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $87.10 Typical High $87.10 | Professional | 56 · Pre-op care only | $87.10 | $87.10 | $87.10 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $630.96 Median $851.14 Typical High $1,174.90 | Professional | None | $630.96 | $851.14 | $1,174.90 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $489.78 Typical High $575.44 | Professional | 54 · Surgery only | $407.38 | $489.78 | $575.44 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $151.36 Typical High $177.83 | Professional | 55 · Aftercare only | $123.03 | $151.36 | $177.83 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $72.44 Typical High $85.11 | Professional | 56 · Pre-op care only | $58.88 | $72.44 | $85.11 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $2,754.23 Typical High $3,981.07 | Facility | None | $676.08 | $2,754.23 | $3,981.07 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $1,258.93 Typical High $1,318.26 | Professional | None | $933.25 | $1,258.93 | $1,318.26 |
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 $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 $436.52 Median $436.52 Typical High $436.52 | Professional | 52 · Reduced service | $436.52 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | 53 · Discontinued | $173.78 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $602.56 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $602.56 | $602.56 | $602.56 |
Where Rhode Island sits
The same service costs 8.5 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· 32nd 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.