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 $446.68 Median $549.54 Typical High $1,584.89 | Professional | None | $446.68 | $549.54 | $1,584.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $416.87 Typical High $1,202.26 | Professional | 54 · Surgery only | $331.13 | $416.87 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $83.18 Typical High $239.88 | Professional | 55 · Aftercare only | $67.61 | $83.18 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $54.95 Typical High $158.49 | Professional | 56 · Pre-op care only | $44.67 | $54.95 | $158.49 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $426.58 Median $758.58 Typical High $2,344.23 | Professional | None | $426.58 | $758.58 | $2,344.23 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $588.84 Typical High $1,659.59 | Professional | 54 · Surgery only | $281.84 | $588.84 | $1,659.59 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $74.13 Typical High $204.17 | Professional | 55 · Aftercare only | $35.48 | $74.13 | $204.17 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $74.13 Typical High $204.17 | Professional | 56 · Pre-op care only | $35.48 | $74.13 | $204.17 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $2,137.96 Typical High $3,019.95 | Facility | None | $676.08 | $2,137.96 | $3,019.95 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $891.25 Typical High $2,818.38 | Professional | None | $602.56 | $891.25 | $2,818.38 |
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 $426.58 Median $1,047.13 Typical High $2,344.23 | Professional | None | $426.58 | $1,047.13 | $2,344.23 |
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 $223.87 Median $275.42 Typical High $794.33 | Professional | 52 · Reduced service | $223.87 | $275.42 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $109.65 Typical High $316.23 | Professional | 53 · Discontinued | $89.13 | $109.65 | $316.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $389.05 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $309.03 | $389.05 | $1,122.02 |
Where Rhode Island sits
The same service costs 4.4 times more in Alaska than in Nebraska. 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· 31st of 51
$1,349
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.