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 $467.74 Median $467.74 Typical High $645.65 | Professional | None | $467.74 | $467.74 | $645.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $346.74 Typical High $478.63 | Professional | 54 · Surgery only | $346.74 | $346.74 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $69.18 Typical High $95.50 | Professional | 55 · Aftercare only | $69.18 | $69.18 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $46.77 Typical High $64.57 | Professional | 56 · Pre-op care only | $46.77 | $46.77 | $64.57 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $426.58 Median $602.56 Typical High $870.96 | Professional | None | $426.58 | $602.56 | $870.96 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $407.38 Typical High $602.56 | Professional | 54 · Surgery only | $288.40 | $407.38 | $602.56 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $50.12 Typical High $75.86 | Professional | 55 · Aftercare only | $35.48 | $50.12 | $75.86 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $45.71 Typical High $67.61 | Professional | 56 · Pre-op care only | $31.62 | $45.71 | $67.61 |
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 $588.84 Median $794.33 Typical High $1,096.48 | Professional | None | $588.84 | $794.33 | $1,096.48 |
United Setting Facility Modifier None Typical Low $645.65 Median $1,445.44 Typical High $5,754.40 | Facility | None | $645.65 | $1,445.44 | $5,754.40 |
United Setting Professional Modifier None Typical Low $331.13 Median $501.19 Typical High $912.01 | Professional | None | $331.13 | $501.19 | $912.01 |
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 $234.42 Median $234.42 Typical High $323.59 | Professional | 52 · Reduced service | $234.42 | $234.42 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $93.33 Typical High $128.82 | Professional | 53 · Discontinued | $93.33 | $93.33 | $128.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $323.59 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $323.59 | $323.59 | $446.68 |
Where Rhode Island sits
The same service costs 4.4 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· 27th 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.