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 $3,019.95 Median $3,715.35 Typical High $3,981.07 | Facility | None | $3,019.95 | $3,715.35 | $3,981.07 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $549.54 Typical High $676.08 | Professional | None | $489.78 | $549.54 | $676.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $407.38 Typical High $512.86 | Professional | 54 · Surgery only | $363.08 | $407.38 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $83.18 Typical High $102.33 | Professional | 55 · Aftercare only | $74.13 | $83.18 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $54.95 Typical High $67.61 | Professional | 56 · Pre-op care only | $48.98 | $54.95 | $67.61 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $371.54 Median $524.81 Typical High $758.58 | Professional | None | $371.54 | $524.81 | $758.58 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $302.00 Typical High $426.58 | Professional | 54 · Surgery only | $213.80 | $302.00 | $426.58 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $93.33 Typical High $128.82 | Professional | 55 · Aftercare only | $64.57 | $93.33 | $128.82 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $43.65 Typical High $61.66 | Professional | 56 · Pre-op care only | $30.90 | $43.65 | $61.66 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $1,202.26 Typical High $1,698.24 | Facility | None | $831.76 | $1,202.26 | $1,698.24 |
Cigna Setting Professional Modifier None Typical Low $645.65 Median $691.83 Typical High $933.25 | Professional | None | $645.65 | $691.83 | $933.25 |
United Setting Facility Modifier None Typical Low $371.54 Median $1,096.48 Typical High $4,265.80 | Facility | None | $371.54 | $1,096.48 | $4,265.80 |
United Setting Professional Modifier None Typical Low $316.23 Median $489.78 Typical High $851.14 | Professional | None | $316.23 | $489.78 | $851.14 |
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 $245.47 Median $275.42 Typical High $338.84 | Professional | 52 · Reduced service | $245.47 | $275.42 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $109.65 Typical High $138.04 | Professional | 53 · Discontinued | $97.72 | $109.65 | $138.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $380.19 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $338.84 | $380.19 | $478.63 |
Where Rhode Island sits
The same service costs 4.8 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
$617
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.