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 $2,398.83 Median $3,235.94 Typical High $3,981.07 | Facility | None | $2,398.83 | $3,235.94 | $3,981.07 |
Aetna Setting Professional Modifier None Typical Low $977.24 Median $1,122.02 Typical High $1,122.02 | Professional | None | $977.24 | $1,122.02 | $1,122.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $851.14 Typical High $851.14 | Professional | 54 · Surgery only | $724.44 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $169.82 Typical High $169.82 | Professional | 55 · Aftercare only | $144.54 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $112.20 Typical High $112.20 | Professional | 56 · Pre-op care only | $97.72 | $112.20 | $112.20 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $1,071.52 Median $1,258.93 Typical High $1,698.24 | Professional | None | $1,071.52 | $1,258.93 | $1,698.24 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $870.96 Typical High $1,047.13 | Professional | 54 · Surgery only | $616.60 | $870.96 | $1,047.13 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $251.19 Typical High $302.00 | Professional | 55 · Aftercare only | $173.78 | $251.19 | $302.00 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $125.89 Typical High $151.36 | Professional | 56 · Pre-op care only | $87.10 | $125.89 | $151.36 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $2,238.72 Typical High $3,235.94 | Facility | None | $676.08 | $2,238.72 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $1,000.00 Median $1,949.84 Typical High $1,949.84 | Professional | None | $1,000.00 | $1,949.84 | $1,949.84 |
United Setting Facility Modifier None Typical Low $812.83 Median $2,630.27 Typical High $8,709.64 | Facility | None | $812.83 | $2,630.27 | $8,709.64 |
United Setting Professional Modifier None Typical Low $794.33 Median $891.25 Typical High $1,513.56 | Professional | None | $794.33 | $891.25 | $1,513.56 |
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 $489.78 Median $562.34 Typical High $562.34 | Professional | 52 · Reduced service | $489.78 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $223.87 Typical High $223.87 | Professional | 53 · Discontinued | $194.98 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $794.33 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $676.08 | $794.33 | $794.33 |
Where Rhode Island sits
The same service costs 7.2 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· 30th of 51
$1,259
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.