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 $302.00 Median $457.09 Typical High $676.08 | Professional | None | $302.00 | $457.09 | $676.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $263.03 Typical High $416.87 | Professional | 54 · Surgery only | $229.09 | $263.03 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $53.70 Typical High $83.18 | Professional | 55 · Aftercare only | $45.71 | $53.70 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $35.48 Typical High $56.23 | Professional | 56 · Pre-op care only | $30.20 | $35.48 | $56.23 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $245.47 Median $354.81 Typical High $676.08 | Professional | None | $245.47 | $354.81 | $676.08 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $234.42 Typical High $371.54 | Professional | 54 · Surgery only | $162.18 | $234.42 | $371.54 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $28.84 Typical High $46.77 | Professional | 55 · Aftercare only | $20.42 | $28.84 | $46.77 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $28.84 Typical High $46.77 | Professional | 56 · Pre-op care only | $20.42 | $28.84 | $46.77 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $1,318.26 Typical High $1,862.09 | Facility | None | $588.84 | $1,318.26 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $478.63 Typical High $758.58 | Professional | None | $316.23 | $478.63 | $758.58 |
United Setting Facility Modifier None Typical Low $870.96 Median $2,089.30 Typical High $5,888.44 | Facility | None | $870.96 | $2,089.30 | $5,888.44 |
United Setting Professional Modifier None Typical Low $245.47 Median $389.05 Typical High $645.65 | Professional | None | $245.47 | $389.05 | $645.65 |
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 $151.36 Median $177.83 Typical High $281.84 | Professional | 52 · Reduced service | $151.36 | $177.83 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $70.79 Typical High $112.20 | Professional | 53 · Discontinued | $60.26 | $70.79 | $112.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $213.80 Median $245.47 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $213.80 | $245.47 | $389.05 |
Where Rhode Island sits
The same service costs 4.6 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· 28th of 51
$427
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.