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 $398.11 Median $446.68 Typical High $575.44 | Professional | None | $398.11 | $446.68 | $575.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $338.84 Typical High $426.58 | Professional | 54 · Surgery only | $295.12 | $338.84 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $67.61 Typical High $85.11 | Professional | 55 · Aftercare only | $60.26 | $67.61 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $44.67 Typical High $57.54 | Professional | 56 · Pre-op care only | $39.81 | $44.67 | $57.54 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $316.23 Median $457.09 Typical High $630.96 | Professional | None | $316.23 | $457.09 | $630.96 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $257.04 Typical High $371.54 | Professional | 54 · Surgery only | $177.83 | $257.04 | $371.54 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $79.43 Typical High $112.20 | Professional | 55 · Aftercare only | $53.70 | $79.43 | $112.20 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $37.15 Typical High $53.70 | Professional | 56 · Pre-op care only | $25.70 | $37.15 | $53.70 |
Cigna Setting Facility Modifier None Typical Low $338.84 Median $457.09 Typical High $1,202.26 | Facility | None | $338.84 | $457.09 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $630.96 Typical High $812.83 | Professional | None | $537.03 | $630.96 | $812.83 |
United Setting Facility Modifier None Typical Low $870.96 Median $2,089.30 Typical High $5,888.44 | Facility | None | $870.96 | $2,089.30 | $5,888.44 |
United Setting Professional Modifier None Typical Low $263.03 Median $407.38 Typical High $741.31 | Professional | None | $263.03 | $407.38 | $741.31 |
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 $199.53 Median $223.87 Typical High $288.40 | Professional | 52 · Reduced service | $199.53 | $223.87 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $89.13 Typical High $114.82 | Professional | 53 · Discontinued | $79.43 | $89.13 | $114.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $316.23 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $275.42 | $316.23 | $398.11 |
Where Rhode Island sits
The same service costs 4.5 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· 17th of 51
$537
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.