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 $794.33 Median $831.76 Typical High $1,000.00 | Professional | None | $794.33 | $831.76 | $1,000.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $630.96 Typical High $758.58 | Professional | 54 · Surgery only | $602.56 | $630.96 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $125.89 Typical High $151.36 | Professional | 55 · Aftercare only | $120.23 | $125.89 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $83.18 Typical High $100.00 | Professional | 56 · Pre-op care only | $79.43 | $83.18 | $100.00 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $707.95 Median $954.99 Typical High $1,380.38 | Professional | None | $707.95 | $954.99 | $1,380.38 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $676.08 Typical High $1,000.00 | Professional | 54 · Surgery only | $467.74 | $676.08 | $1,000.00 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $83.18 Typical High $123.03 | Professional | 55 · Aftercare only | $57.54 | $83.18 | $123.03 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $74.13 Typical High $112.20 | Professional | 56 · Pre-op care only | $52.48 | $74.13 | $112.20 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $3,981.07 Typical High $5,623.41 | Facility | None | $676.08 | $3,981.07 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $912.01 Median $1,202.26 Typical High $1,584.89 | Professional | None | $912.01 | $1,202.26 | $1,584.89 |
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 $616.60 Median $870.96 Typical High $1,445.44 | Professional | None | $616.60 | $870.96 | $1,445.44 |
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 $398.11 Median $416.87 Typical High $501.19 | Professional | 52 · Reduced service | $398.11 | $416.87 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $169.82 Typical High $204.17 | Professional | 53 · Discontinued | $158.49 | $169.82 | $204.17 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $588.84 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $562.34 | $588.84 | $707.95 |
Where Rhode Island sits
The same service costs 5.2 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· 30th of 51
$1,000
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.