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 $794.33 Median $794.33 Typical High $794.33 | Professional | None | $794.33 | $794.33 | $794.33 |
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 $79.43 Median $79.43 Typical High $79.43 | Professional | 56 · Pre-op care only | $79.43 | $79.43 | $79.43 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $478.63 Median $645.65 Typical High $912.01 | Professional | None | $478.63 | $645.65 | $912.01 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $371.54 Typical High $436.52 | Professional | 54 · Surgery only | $309.03 | $371.54 | $436.52 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $114.82 Typical High $134.90 | Professional | 55 · Aftercare only | $93.33 | $114.82 | $134.90 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $53.70 Typical High $64.57 | Professional | 56 · Pre-op care only | $44.67 | $53.70 | $64.57 |
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 $933.25 Median $933.25 Typical High $1,122.02 | Professional | None | $933.25 | $933.25 | $1,122.02 |
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 $436.52 Median $724.44 Typical High $1,096.48 | Professional | None | $436.52 | $724.44 | $1,096.48 |
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 6.6 times more in Alaska than in Utah. 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· 26th of 51
$794
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.