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 $707.95 Median $707.95 Typical High $707.95 | Professional | None | $707.95 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $537.03 Typical High $537.03 | Professional | 54 · Surgery only | $537.03 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $107.15 Typical High $107.15 | Professional | 55 · Aftercare only | $107.15 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $70.79 Typical High $70.79 | Professional | 56 · Pre-op care only | $70.79 | $70.79 | $70.79 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $707.95 Median $831.76 Typical High $831.76 | Professional | None | $707.95 | $831.76 | $831.76 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $575.44 Typical High $676.08 | Professional | 54 · Surgery only | $398.11 | $575.44 | $676.08 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $70.79 Typical High $83.18 | Professional | 55 · Aftercare only | $48.98 | $70.79 | $83.18 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $63.10 Typical High $74.13 | Professional | 56 · Pre-op care only | $44.67 | $63.10 | $74.13 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $1,862.09 Typical High $2,691.53 | Facility | None | $676.08 | $1,862.09 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $1,000.00 Median $1,023.29 Typical High $1,023.29 | Professional | None | $1,000.00 | $1,023.29 | $1,023.29 |
United Setting Facility Modifier None Typical Low $870.96 Median $2,089.30 Typical High $6,165.95 | Facility | None | $870.96 | $2,089.30 | $6,165.95 |
United Setting Professional Modifier None Typical Low $524.81 Median $602.56 Typical High $912.01 | Professional | None | $524.81 | $602.56 | $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 $354.81 Median $354.81 Typical High $354.81 | Professional | 52 · Reduced service | $354.81 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | 53 · Discontinued | $144.54 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $501.19 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $501.19 | $501.19 | $501.19 |
Where Rhode Island sits
The same service costs 5.6 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· 30th of 51
$741
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.