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 $3,019.95 Median $3,715.35 Typical High $3,981.07 | Facility | None | $3,019.95 | $3,715.35 | $3,981.07 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $776.25 Typical High $776.25 | Professional | None | $776.25 | $776.25 | $776.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $588.84 Typical High $588.84 | Professional | 54 · Surgery only | $588.84 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $117.49 Typical High $117.49 | Professional | 55 · Aftercare only | $117.49 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $77.62 Typical High $77.62 | Professional | 56 · Pre-op care only | $77.62 | $77.62 | $77.62 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $562.34 Median $758.58 Typical High $1,071.52 | Professional | None | $562.34 | $758.58 | $1,071.52 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $446.68 Typical High $524.81 | Professional | 54 · Surgery only | $363.08 | $446.68 | $524.81 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $134.90 Typical High $158.49 | Professional | 55 · Aftercare only | $112.20 | $134.90 | $158.49 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $64.57 Typical High $75.86 | Professional | 56 · Pre-op care only | $52.48 | $64.57 | $75.86 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $1,412.54 Typical High $1,698.24 | Facility | None | $831.76 | $1,412.54 | $1,698.24 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $1,122.02 Typical High $1,258.93 | Professional | None | $851.14 | $1,122.02 | $1,258.93 |
United Setting Facility Modifier None Typical Low $812.83 Median $2,630.27 Typical High $7,762.47 | Facility | None | $812.83 | $2,630.27 | $7,762.47 |
United Setting Professional Modifier None Typical Low $512.86 Median $645.65 Typical High $1,174.90 | Professional | None | $512.86 | $645.65 | $1,174.90 |
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 $389.05 Median $389.05 Typical High $389.05 | Professional | 52 · Reduced service | $389.05 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | 53 · Discontinued | $154.88 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $549.54 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $549.54 | $549.54 | $549.54 |
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· 32nd of 51
$776
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.