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 $467.74 Typical High $478.63 | Professional | None | $389.05 | $467.74 | $478.63 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $302.00 Typical High $363.08 | Professional | 54 · Surgery only | $288.40 | $302.00 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $60.26 Typical High $72.44 | Professional | 55 · Aftercare only | $57.54 | $60.26 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $40.74 Typical High $47.86 | Professional | 56 · Pre-op care only | $38.90 | $40.74 | $47.86 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $331.13 Median $426.58 Typical High $676.08 | Professional | None | $331.13 | $426.58 | $676.08 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $316.23 Typical High $501.19 | Professional | 54 · Surgery only | $218.78 | $316.23 | $501.19 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $38.90 Typical High $61.66 | Professional | 55 · Aftercare only | $26.92 | $38.90 | $61.66 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $34.67 Typical High $54.95 | Professional | 56 · Pre-op care only | $24.55 | $34.67 | $54.95 |
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 $436.52 Median $537.03 Typical High $676.08 | Professional | None | $436.52 | $537.03 | $676.08 |
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 $281.84 Median $380.19 Typical High $616.60 | Professional | None | $281.84 | $380.19 | $616.60 |
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 $204.17 Typical High $239.88 | Professional | 52 · Reduced service | $194.98 | $204.17 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $81.28 Typical High $97.72 | Professional | 53 · Discontinued | $77.62 | $81.28 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $269.15 Median $281.84 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $269.15 | $281.84 | $338.84 |
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· 27th of 51
$468
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.