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 $457.09 Median $457.09 Typical High $478.63 | Professional | None | $457.09 | $457.09 | $478.63 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $346.74 Typical High $346.74 | Professional | 54 · Surgery only | $346.74 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $69.18 Typical High $69.18 | Professional | 55 · Aftercare only | $69.18 | $69.18 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $45.71 Typical High $45.71 | Professional | 56 · Pre-op care only | $45.71 | $45.71 | $45.71 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $316.23 Median $416.87 Typical High $691.83 | Professional | None | $316.23 | $416.87 | $691.83 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $263.03 Typical High $436.52 | Professional | 54 · Surgery only | $181.97 | $263.03 | $436.52 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $50.12 Typical High $81.28 | Professional | 55 · Aftercare only | $34.67 | $50.12 | $81.28 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $42.66 Typical High $70.79 | Professional | 56 · Pre-op care only | $29.51 | $42.66 | $70.79 |
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 $389.05 Median $602.56 Typical High $707.95 | Professional | None | $389.05 | $602.56 | $707.95 |
United Setting Facility Modifier None Typical Low $645.65 Median $1,348.96 Typical High $5,011.87 | Facility | None | $645.65 | $1,348.96 | $5,011.87 |
United Setting Professional Modifier None Typical Low $302.00 Median $426.58 Typical High $602.56 | Professional | None | $302.00 | $426.58 | $602.56 |
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 $229.09 Median $229.09 Typical High $229.09 | Professional | 52 · Reduced service | $229.09 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $91.20 Typical High $91.20 | Professional | 53 · Discontinued | $91.20 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $323.59 Typical High $323.59 | Professional | 78 · Unplanned return to OR | $323.59 | $323.59 | $323.59 |
Where Rhode Island sits
The same service costs 5.8 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· 31st of 51
$457
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.