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 $1,513.56 Median $1,548.82 Typical High $3,981.07 | Facility | None | $1,513.56 | $1,548.82 | $3,981.07 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $489.78 | Professional | None | $489.78 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $363.08 Typical High $363.08 | Professional | 54 · Surgery only | $363.08 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $72.44 Typical High $72.44 | Professional | 55 · Aftercare only | $72.44 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $48.98 Typical High $48.98 | Professional | 56 · Pre-op care only | $48.98 | $48.98 | $48.98 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $524.81 Median $616.60 Typical High $616.60 | Professional | None | $524.81 | $616.60 | $616.60 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $426.58 Typical High $501.19 | Professional | 54 · Surgery only | $295.12 | $426.58 | $501.19 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $52.48 Typical High $61.66 | Professional | 55 · Aftercare only | $36.31 | $52.48 | $61.66 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $46.77 Typical High $54.95 | Professional | 56 · Pre-op care only | $33.11 | $46.77 | $54.95 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $1,949.84 Typical High $2,754.23 | Facility | None | $446.68 | $1,949.84 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $776.25 Typical High $776.25 | Professional | None | $602.56 | $776.25 | $776.25 |
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 $389.05 Median $426.58 Typical High $676.08 | Professional | None | $389.05 | $426.58 | $676.08 |
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 $245.47 Median $245.47 Typical High $245.47 | Professional | 52 · Reduced service | $245.47 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $97.72 Typical High $97.72 | Professional | 53 · Discontinued | $97.72 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $338.84 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $338.84 | $338.84 | $338.84 |
Where Rhode Island sits
The same service costs 6.2 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· 24th of 51
$562
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.