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 $707.95 | Professional | None | $446.68 | $478.63 | $707.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $338.84 Typical High $354.81 | Professional | 54 · Surgery only | $338.84 | $338.84 | $354.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $67.61 Typical High $70.79 | Professional | 55 · Aftercare only | $67.61 | $67.61 | $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 $436.52 Typical High $741.31 | Professional | None | $363.08 | $436.52 | $741.31 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $338.84 Typical High $524.81 | Professional | 54 · Surgery only | $239.88 | $338.84 | $524.81 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $42.66 Typical High $66.07 | Professional | 55 · Aftercare only | $30.20 | $42.66 | $66.07 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $42.66 Typical High $66.07 | Professional | 56 · Pre-op care only | $30.20 | $42.66 | $66.07 |
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 $380.19 Median $436.52 Typical High $870.96 | Professional | None | $380.19 | $436.52 | $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 $416.87 Typical High $707.95 | Professional | None | $302.00 | $416.87 | $707.95 |
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 $234.42 | Professional | 52 · Reduced service | $223.87 | $223.87 | $234.42 |
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 $316.23 Median $316.23 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $316.23 | $316.23 | $331.13 |
Where Rhode Island sits
The same service costs 3.8 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· 39th 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.