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 $831.76 Median $1,000.00 Typical High $1,288.25 | Professional | None | $831.76 | $1,000.00 | $1,288.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $676.08 Typical High $812.83 | Professional | 54 · Surgery only | $676.08 | $676.08 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $134.90 Typical High $162.18 | Professional | 55 · Aftercare only | $134.90 | $134.90 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $89.13 Typical High $107.15 | Professional | 56 · Pre-op care only | $89.13 | $89.13 | $107.15 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $724.44 Median $891.25 Typical High $1,479.11 | Professional | None | $724.44 | $891.25 | $1,479.11 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $562.34 Typical High $933.25 | Professional | 54 · Surgery only | $426.58 | $562.34 | $933.25 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $151.36 Typical High $251.19 | Professional | 55 · Aftercare only | $114.82 | $151.36 | $251.19 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $79.43 Typical High $131.83 | Professional | 56 · Pre-op care only | $60.26 | $79.43 | $131.83 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $1,479.11 Typical High $2,089.30 | Facility | None | $676.08 | $1,479.11 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $933.25 Typical High $2,089.30 | Professional | None | $758.58 | $933.25 | $2,089.30 |
United Setting Facility Modifier None Typical Low $645.65 Median $1,445.44 Typical High $5,011.87 | Facility | None | $645.65 | $1,445.44 | $5,011.87 |
United Setting Professional Modifier None Typical Low $724.44 Median $1,047.13 Typical High $1,778.28 | Professional | None | $724.44 | $1,047.13 | $1,778.28 |
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 $446.68 Median $446.68 Typical High $537.03 | Professional | 52 · Reduced service | $446.68 | $446.68 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $181.97 Typical High $213.80 | Professional | 53 · Discontinued | $181.97 | $181.97 | $213.80 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $630.96 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $630.96 | $630.96 | $758.58 |
Where Rhode Island sits
The same service costs 4.5 times more in Alaska than in Texas. 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· 29th of 51
$1,047
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.