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 $371.54 Median $426.58 Typical High $549.54 | Professional | None | $371.54 | $426.58 | $549.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $316.23 Typical High $407.38 | Professional | 54 · Surgery only | $281.84 | $316.23 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $63.10 Typical High $83.18 | Professional | 55 · Aftercare only | $56.23 | $63.10 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $42.66 Typical High $54.95 | Professional | 56 · Pre-op care only | $37.15 | $42.66 | $54.95 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $295.12 Median $436.52 Typical High $602.56 | Professional | None | $295.12 | $436.52 | $602.56 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $251.19 Typical High $354.81 | Professional | 54 · Surgery only | $165.96 | $251.19 | $354.81 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $75.86 Typical High $109.65 | Professional | 55 · Aftercare only | $51.29 | $75.86 | $109.65 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $36.31 Typical High $51.29 | Professional | 56 · Pre-op care only | $23.99 | $36.31 | $51.29 |
Cigna Setting Facility Modifier None Typical Low $331.13 Median $446.68 Typical High $1,202.26 | Facility | None | $331.13 | $446.68 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $501.19 Median $588.84 Typical High $776.25 | Professional | None | $501.19 | $588.84 | $776.25 |
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 $245.47 Median $398.11 Typical High $707.95 | Professional | None | $245.47 | $398.11 | $707.95 |
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 $186.21 Median $208.93 Typical High $275.42 | Professional | 52 · Reduced service | $186.21 | $208.93 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $85.11 Typical High $109.65 | Professional | 53 · Discontinued | $74.13 | $85.11 | $109.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $263.03 Median $295.12 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $263.03 | $295.12 | $380.19 |
Where Rhode Island sits
The same service costs 4.7 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· 19th of 51
$501
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.