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 $2,398.83 Median $3,235.94 Typical High $3,981.07 | Facility | None | $2,398.83 | $3,235.94 | $3,981.07 |
Aetna Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,380.38 | Professional | None | $1,380.38 | $1,380.38 | $1,380.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,023.29 Typical High $1,023.29 | Professional | 54 · Surgery only | $1,023.29 | $1,023.29 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $204.17 Typical High $204.17 | Professional | 55 · Aftercare only | $204.17 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | 56 · Pre-op care only | $138.04 | $138.04 | $138.04 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $954.99 Median $1,258.93 Typical High $1,819.70 | Professional | None | $954.99 | $1,258.93 | $1,819.70 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $741.31 Typical High $870.96 | Professional | 54 · Surgery only | $616.60 | $741.31 | $870.96 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $223.87 Typical High $263.03 | Professional | 55 · Aftercare only | $186.21 | $223.87 | $263.03 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $107.15 Typical High $125.89 | Professional | 56 · Pre-op care only | $89.13 | $107.15 | $125.89 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $4,786.30 Typical High $6,918.31 | Facility | None | $676.08 | $4,786.30 | $6,918.31 |
Cigna Setting Professional Modifier None Typical Low $1,513.56 Median $1,862.09 Typical High $2,137.96 | Professional | None | $1,513.56 | $1,862.09 | $2,137.96 |
United Setting Facility Modifier None Typical Low $1,023.29 Median $4,570.88 Typical High $12,882.50 | Facility | None | $1,023.29 | $4,570.88 | $12,882.50 |
United Setting Professional Modifier None Typical Low $870.96 Median $1,174.90 Typical High $1,949.84 | Professional | None | $870.96 | $1,174.90 | $1,949.84 |
1 more rate 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 78 · Unplanned return to OR Typical Low $954.99 Median $954.99 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $954.99 | $954.99 | $954.99 |
Where Rhode Island sits
The same service costs 7.6 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· 29th of 51
$1,380
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.