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 $977.24 Median $977.24 Typical High $977.24 | Professional | None | $977.24 | $977.24 | $977.24 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $724.44 Typical High $724.44 | Professional | 54 · Surgery only | $724.44 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | 55 · Aftercare only | $144.54 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $97.72 Typical High $97.72 | Professional | 56 · Pre-op care only | $97.72 | $97.72 | $97.72 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $660.69 Median $891.25 Typical High $1,479.11 | Professional | None | $660.69 | $891.25 | $1,479.11 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $602.56 Typical High $1,000.00 | Professional | 54 · Surgery only | $426.58 | $602.56 | $1,000.00 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $75.86 Typical High $125.89 | Professional | 55 · Aftercare only | $52.48 | $75.86 | $125.89 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $75.86 Typical High $125.89 | Professional | 56 · Pre-op care only | $52.48 | $75.86 | $125.89 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $3,548.13 Typical High $5,128.61 | Facility | None | $676.08 | $3,548.13 | $5,128.61 |
Cigna Setting Professional Modifier None Typical Low $977.24 Median $1,348.96 Typical High $1,513.56 | Professional | None | $977.24 | $1,348.96 | $1,513.56 |
United Setting Facility Modifier None Typical Low $933.25 Median $3,548.13 Typical High $11,748.98 | Facility | None | $933.25 | $3,548.13 | $11,748.98 |
United Setting Professional Modifier None Typical Low $645.65 Median $912.01 Typical High $1,288.25 | Professional | None | $645.65 | $912.01 | $1,288.25 |
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 $489.78 Median $489.78 Typical High $489.78 | Professional | 52 · Reduced service | $489.78 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $194.98 Typical High $194.98 | Professional | 53 · Discontinued | $194.98 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $676.08 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $676.08 | $676.08 | $676.08 |
Where Rhode Island sits
The same service costs 8.7 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· 34th of 51
$977
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.