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 $3,467.37 Median $3,715.35 Typical High $3,981.07 | Facility | None | $3,467.37 | $3,715.35 | $3,981.07 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $812.83 | Professional | None | $812.83 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $602.56 Typical High $602.56 | Professional | 54 · Surgery only | $602.56 | $602.56 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | 55 · Aftercare only | $120.23 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $81.28 Typical High $81.28 | Professional | 56 · Pre-op care only | $81.28 | $81.28 | $81.28 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $537.03 Median $724.44 Typical High $1,230.27 | Professional | None | $537.03 | $724.44 | $1,230.27 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $512.86 Typical High $851.14 | Professional | 54 · Surgery only | $354.81 | $512.86 | $851.14 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $54.95 Typical High $93.33 | Professional | 55 · Aftercare only | $38.90 | $54.95 | $93.33 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $48.98 Typical High $83.18 | Professional | 56 · Pre-op care only | $34.67 | $48.98 | $83.18 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $3,019.95 Typical High $4,265.80 | Facility | None | $676.08 | $3,019.95 | $4,265.80 |
Cigna Setting Professional Modifier None Typical Low $794.33 Median $1,096.48 Typical High $1,230.27 | Professional | None | $794.33 | $1,096.48 | $1,230.27 |
United Setting Facility Modifier None Typical Low $933.25 Median $3,548.13 Typical High $10,964.78 | Facility | None | $933.25 | $3,548.13 | $10,964.78 |
United Setting Professional Modifier None Typical Low $524.81 Median $758.58 Typical High $1,047.13 | Professional | None | $524.81 | $758.58 | $1,047.13 |
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 $407.38 Median $407.38 Typical High $407.38 | Professional | 52 · Reduced service | $407.38 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | 53 · Discontinued | $162.18 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $562.34 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $562.34 | $562.34 | $562.34 |
Where Rhode Island sits
The same service costs 9.8 times more in Oklahoma 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· 33rd of 51
$813
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.