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 $416.87 Median $467.74 Typical High $602.56 | Professional | None | $416.87 | $467.74 | $602.56 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $346.74 Typical High $457.09 | Professional | 54 · Surgery only | $309.03 | $346.74 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $70.79 Typical High $91.20 | Professional | 55 · Aftercare only | $61.66 | $70.79 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $46.77 Typical High $60.26 | Professional | 56 · Pre-op care only | $41.69 | $46.77 | $60.26 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $323.59 Median $467.74 Typical High $645.65 | Professional | None | $323.59 | $467.74 | $645.65 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $263.03 Typical High $380.19 | Professional | 54 · Surgery only | $181.97 | $263.03 | $380.19 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $81.28 Typical High $114.82 | Professional | 55 · Aftercare only | $54.95 | $81.28 | $114.82 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $38.02 Typical High $54.95 | Professional | 56 · Pre-op care only | $26.30 | $38.02 | $54.95 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $1,047.13 Typical High $1,380.38 | Facility | None | $588.84 | $1,047.13 | $1,380.38 |
Cigna Setting Professional Modifier None Typical Low $549.54 Median $616.60 Typical High $831.76 | Professional | None | $549.54 | $616.60 | $831.76 |
United Setting Facility Modifier None Typical Low $645.65 Median $1,445.44 Typical High $5,011.87 | Facility | None | $645.65 | $1,445.44 | $5,011.87 |
United Setting Professional Modifier None Typical Low $269.15 Median $426.58 Typical High $758.58 | Professional | None | $269.15 | $426.58 | $758.58 |
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 $208.93 Median $234.42 Typical High $302.00 | Professional | 52 · Reduced service | $208.93 | $234.42 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $93.33 Typical High $120.23 | Professional | 53 · Discontinued | $83.18 | $93.33 | $120.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $323.59 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $288.40 | $323.59 | $426.58 |
Where Rhode Island sits
The same service costs 4.9 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· 21st of 51
$550
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.