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 $1,659.59 Median $1,659.59 Typical High $1,659.59 | Professional | None | $1,659.59 | $1,659.59 | $1,659.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,258.93 Median $1,258.93 Typical High $1,258.93 | Professional | 54 · Surgery only | $1,258.93 | $1,258.93 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $251.19 Median $251.19 Typical High $251.19 | Professional | 55 · Aftercare only | $251.19 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | 56 · Pre-op care only | $165.96 | $165.96 | $165.96 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $1,148.15 Median $1,548.82 Typical High $2,187.76 | Professional | None | $1,148.15 | $1,548.82 | $2,187.76 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $891.25 Typical High $1,047.13 | Professional | 54 · Surgery only | $741.31 | $891.25 | $1,047.13 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $275.42 Typical High $323.59 | Professional | 55 · Aftercare only | $223.87 | $275.42 | $323.59 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $128.82 Typical High $154.88 | Professional | 56 · Pre-op care only | $107.15 | $128.82 | $154.88 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $11,220.18 Typical High $16,218.10 | Facility | None | $676.08 | $11,220.18 | $16,218.10 |
Cigna Setting Professional Modifier None Typical Low $1,819.70 Median $2,290.87 Typical High $2,630.27 | Professional | None | $1,819.70 | $2,290.87 | $2,630.27 |
United Setting Facility Modifier None Typical Low $1,023.29 Median $4,570.88 Typical High $12,882.50 | Facility | None | $1,023.29 | $4,570.88 | $12,882.50 |
United Setting Professional Modifier None Typical Low $1,047.13 Median $1,445.44 Typical High $2,398.83 | Professional | None | $1,047.13 | $1,445.44 | $2,398.83 |
1 more rate 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 78 · Unplanned return to OR Typical Low $1,174.90 Median $1,174.90 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $1,174.90 | $1,174.90 | $1,174.90 |
Where Rhode Island sits
The same service costs 8.1 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· 28th of 51
$1,660
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.