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 $870.96 Median $870.96 Typical High $870.96 | Professional | None | $870.96 | $870.96 | $870.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $645.65 Typical High $645.65 | Professional | 54 · Surgery only | $645.65 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $131.83 Typical High $131.83 | Professional | 55 · Aftercare only | $131.83 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $87.10 Typical High $87.10 | Professional | 56 · Pre-op care only | $87.10 | $87.10 | $87.10 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $602.56 Median $812.83 Typical High $1,096.48 | Professional | None | $602.56 | $812.83 | $1,096.48 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $467.74 Typical High $549.54 | Professional | 54 · Surgery only | $389.05 | $467.74 | $549.54 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $144.54 Typical High $169.82 | Professional | 55 · Aftercare only | $117.49 | $144.54 | $169.82 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $69.18 Typical High $81.28 | Professional | 56 · Pre-op care only | $56.23 | $69.18 | $81.28 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $2,137.96 Typical High $3,090.30 | Facility | None | $676.08 | $2,137.96 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $912.01 Median $1,202.26 Typical High $1,348.96 | Professional | None | $912.01 | $1,202.26 | $1,348.96 |
United Setting Facility Modifier None Typical Low $1,023.29 Median $4,570.88 Typical High $10,471.29 | Facility | None | $1,023.29 | $4,570.88 | $10,471.29 |
United Setting Professional Modifier None Typical Low $549.54 Median $724.44 Typical High $1,258.93 | Professional | None | $549.54 | $724.44 | $1,258.93 |
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 $436.52 Median $436.52 Typical High $436.52 | Professional | 52 · Reduced service | $436.52 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | 53 · Discontinued | $173.78 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $602.56 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $602.56 | $602.56 | $602.56 |
Where Rhode Island sits
The same service costs 16.6 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· 26th of 51
$871
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.