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 $741.31 Median $741.31 Typical High $741.31 | Professional | None | $741.31 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $562.34 Typical High $562.34 | Professional | 54 · Surgery only | $562.34 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $112.20 Typical High $112.20 | Professional | 55 · Aftercare only | $112.20 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $74.13 Typical High $74.13 | Professional | 56 · Pre-op care only | $74.13 | $74.13 | $74.13 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $512.86 Median $691.83 Typical High $1,071.52 | Professional | None | $512.86 | $691.83 | $1,071.52 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $436.52 Typical High $676.08 | Professional | 54 · Surgery only | $302.00 | $436.52 | $676.08 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $83.18 Typical High $128.82 | Professional | 55 · Aftercare only | $57.54 | $83.18 | $128.82 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $70.79 Typical High $109.65 | Professional | 56 · Pre-op care only | $48.98 | $70.79 | $109.65 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $676.08 Typical High $1,202.26 | Facility | None | $50.12 | $676.08 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $645.65 Median $977.24 Typical High $1,148.15 | Professional | None | $645.65 | $977.24 | $1,148.15 |
United Setting Facility Modifier None Typical Low $812.83 Median $2,290.87 Typical High $7,762.47 | Facility | None | $812.83 | $2,290.87 | $7,762.47 |
United Setting Professional Modifier None Typical Low $489.78 Median $691.83 Typical High $977.24 | Professional | None | $489.78 | $691.83 | $977.24 |
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 $371.54 Median $371.54 Typical High $371.54 | Professional | 52 · Reduced service | $371.54 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $147.91 Typical High $147.91 | Professional | 53 · Discontinued | $147.91 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $524.81 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $524.81 | $524.81 | $524.81 |
Where Rhode Island sits
The same service costs 6.0 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· 32nd 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.