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 $380.19 Median $512.86 Typical High $1,412.54 | Professional | None | $380.19 | $512.86 | $1,412.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $389.05 Typical High $1,071.52 | Professional | 54 · Surgery only | $281.84 | $389.05 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $77.62 Typical High $213.80 | Professional | 55 · Aftercare only | $56.23 | $77.62 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $51.29 Typical High $141.25 | Professional | 56 · Pre-op care only | $38.02 | $51.29 | $141.25 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $371.54 Median $660.69 Typical High $2,041.74 | Professional | None | $371.54 | $660.69 | $2,041.74 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $512.86 Typical High $1,479.11 | Professional | 54 · Surgery only | $245.47 | $512.86 | $1,479.11 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $63.10 Typical High $186.21 | Professional | 55 · Aftercare only | $30.90 | $63.10 | $186.21 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $63.10 Typical High $186.21 | Professional | 56 · Pre-op care only | $30.90 | $63.10 | $186.21 |
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 $524.81 Median $776.25 Typical High $3,162.28 | Professional | None | $524.81 | $776.25 | $3,162.28 |
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 $371.54 Median $1,096.48 Typical High $2,630.27 | Professional | None | $371.54 | $1,096.48 | $2,630.27 |
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 $190.55 Median $257.04 Typical High $707.95 | Professional | 52 · Reduced service | $190.55 | $257.04 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $104.71 Typical High $281.84 | Professional | 53 · Discontinued | $75.86 | $104.71 | $281.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $263.03 Median $363.08 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $263.03 | $363.08 | $1,000.00 |
Where Rhode Island sits
The same service costs 5.8 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· 34th of 51
$1,413
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.