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 $1,513.56 Median $1,548.82 Typical High $3,981.07 | Facility | None | $1,513.56 | $1,548.82 | $3,981.07 |
Aetna Setting Professional Modifier None Typical Low $524.81 Median $758.58 Typical High $4,168.69 | Professional | None | $524.81 | $758.58 | $4,168.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $426.58 Typical High $3,090.30 | Professional | 54 · Surgery only | $389.05 | $426.58 | $3,090.30 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $398.11 Typical High $2,884.03 | Professional | 78 · Unplanned return to OR | $363.08 | $398.11 | $2,884.03 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $436.52 Median $851.14 Typical High $1,202.26 | Professional | None | $436.52 | $851.14 | $1,202.26 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $676.08 Typical High $5,370.32 | Professional | 54 · Surgery only | $501.19 | $676.08 | $5,370.32 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $1,258.93 Typical High $2,187.76 | Facility | None | $676.08 | $1,258.93 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $645.65 Median $891.25 Typical High $1,621.81 | Professional | None | $645.65 | $891.25 | $1,621.81 |
United Setting Facility Modifier None Typical Low $870.96 Median $2,089.30 Typical High $7,413.10 | Facility | None | $870.96 | $2,089.30 | $7,413.10 |
United Setting Professional Modifier None Typical Low $363.08 Median $707.95 Typical High $3,019.95 | Professional | None | $363.08 | $707.95 | $3,019.95 |
2 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 |
|---|---|---|---|---|---|
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $85.11 Typical High $676.08 | Professional | 55 · Aftercare only | $63.10 | $85.11 | $676.08 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $85.11 Typical High $676.08 | Professional | 56 · Pre-op care only | $63.10 | $85.11 | $676.08 |
Where Rhode Island sits
The same service costs 4.5 times more in North Carolina than in Washington, DC. 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· 29th of 51
$851
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.