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 $389.05 Median $398.11 Typical High $537.03 | Professional | None | $389.05 | $398.11 | $537.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $295.12 Typical High $398.11 | Professional | 54 · Surgery only | $295.12 | $295.12 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $60.26 Typical High $79.43 | Professional | 55 · Aftercare only | $58.88 | $60.26 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $39.81 Typical High $53.70 | Professional | 56 · Pre-op care only | $38.90 | $39.81 | $53.70 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $354.81 Median $436.52 Typical High $831.76 | Professional | None | $354.81 | $436.52 | $831.76 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $316.23 Typical High $562.34 | Professional | 54 · Surgery only | $218.78 | $316.23 | $562.34 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $57.54 Typical High $102.33 | Professional | 55 · Aftercare only | $40.74 | $57.54 | $102.33 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $41.69 Typical High $74.13 | Professional | 56 · Pre-op care only | $28.84 | $41.69 | $74.13 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $1,949.84 Typical High $2,754.23 | Facility | None | $588.84 | $1,949.84 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $501.19 Median $676.08 Typical High $851.14 | Professional | None | $501.19 | $676.08 | $851.14 |
United Setting Facility Modifier None Typical Low $870.96 Median $2,089.30 Typical High $7,413.10 | Facility | None | $870.96 | $2,089.30 | $7,413.10 |
United Setting Professional Modifier None Typical Low $338.84 Median $489.78 Typical High $741.31 | Professional | None | $338.84 | $489.78 | $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 $194.98 Median $199.53 Typical High $263.03 | Professional | 52 · Reduced service | $194.98 | $199.53 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $79.43 Typical High $107.15 | Professional | 53 · Discontinued | $77.62 | $79.43 | $107.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $275.42 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $275.42 | $275.42 | $371.54 |
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· 36th 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.