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 $3,019.95 Median $3,715.35 Typical High $3,981.07 | Facility | None | $3,019.95 | $3,715.35 | $3,981.07 |
Aetna Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $1,047.13 | Professional | None | $851.14 | $851.14 | $1,047.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $645.65 Typical High $776.25 | Professional | 54 · Surgery only | $645.65 | $645.65 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $128.82 Typical High $158.49 | Professional | 55 · Aftercare only | $128.82 | $128.82 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $85.11 Typical High $104.71 | Professional | 56 · Pre-op care only | $85.11 | $85.11 | $104.71 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $758.58 Median $977.24 Typical High $1,148.15 | Professional | None | $758.58 | $977.24 | $1,148.15 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $724.44 Typical High $933.25 | Professional | 54 · Surgery only | $512.86 | $724.44 | $933.25 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $91.20 Typical High $114.82 | Professional | 55 · Aftercare only | $63.10 | $91.20 | $114.82 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $81.28 Typical High $104.71 | Professional | 56 · Pre-op care only | $56.23 | $81.28 | $104.71 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $3,981.07 Typical High $5,623.41 | Facility | None | $831.76 | $3,981.07 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $1,096.48 Median $1,122.02 Typical High $1,445.44 | Professional | None | $1,096.48 | $1,122.02 | $1,445.44 |
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 $630.96 Median $794.33 Typical High $1,174.90 | Professional | None | $630.96 | $794.33 | $1,174.90 |
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 $426.58 Median $426.58 Typical High $524.81 | Professional | 52 · Reduced service | $426.58 | $426.58 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $169.82 Typical High $208.93 | Professional | 53 · Discontinued | $169.82 | $169.82 | $208.93 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $602.56 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $602.56 | $602.56 | $724.44 |
Where Rhode Island sits
The same service costs 4.4 times more in Alaska than in New Jersey. 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· 22nd 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.