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 $3,467.37 Median $3,715.35 Typical High $3,981.07 | Facility | None | $3,467.37 | $3,715.35 | $3,981.07 |
Aetna Setting Professional Modifier None Typical Low $446.68 Median $478.63 Typical High $758.58 | Professional | None | $446.68 | $478.63 | $758.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $331.13 Typical High $354.81 | Professional | 54 · Surgery only | $331.13 | $331.13 | $354.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $66.07 Typical High $70.79 | Professional | 55 · Aftercare only | $66.07 | $66.07 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $44.67 Typical High $47.86 | Professional | 56 · Pre-op care only | $44.67 | $44.67 | $47.86 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $363.08 Median $446.68 Typical High $724.44 | Professional | None | $363.08 | $446.68 | $724.44 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $263.03 Typical High $398.11 | Professional | 54 · Surgery only | $181.97 | $263.03 | $398.11 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $100.00 Typical High $151.36 | Professional | 55 · Aftercare only | $70.79 | $100.00 | $151.36 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $74.13 Typical High $112.20 | Professional | 56 · Pre-op care only | $51.29 | $74.13 | $112.20 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $2,238.72 Typical High $3,235.94 | Facility | None | $954.99 | $2,238.72 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $446.68 Typical High $870.96 | Professional | None | $389.05 | $446.68 | $870.96 |
United Setting Facility Modifier None Typical Low $870.96 Median $2,089.30 Typical High $7,079.46 | Facility | None | $870.96 | $2,089.30 | $7,079.46 |
United Setting Professional Modifier None Typical Low $302.00 Median $407.38 Typical High $724.44 | Professional | None | $302.00 | $407.38 | $724.44 |
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 $223.87 Median $223.87 Typical High $239.88 | Professional | 52 · Reduced service | $223.87 | $223.87 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $89.13 Typical High $95.50 | Professional | 53 · Discontinued | $89.13 | $89.13 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $309.03 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $309.03 | $309.03 | $331.13 |
Where Rhode Island sits
The same service costs 4.3 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· 38th 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.