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 $1,288.25 Median $1,288.25 Typical High $1,479.11 | Professional | None | $1,288.25 | $1,288.25 | $1,479.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $977.24 Typical High $977.24 | Professional | 54 · Surgery only | $977.24 | $977.24 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $194.98 Typical High $194.98 | Professional | 55 · Aftercare only | $194.98 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $128.82 Typical High $128.82 | Professional | 56 · Pre-op care only | $128.82 | $128.82 | $128.82 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $891.25 Median $1,202.26 Typical High $1,995.26 | Professional | None | $891.25 | $1,202.26 | $1,995.26 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $812.83 Typical High $1,348.96 | Professional | 54 · Surgery only | $562.34 | $812.83 | $1,348.96 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $102.33 Typical High $169.82 | Professional | 55 · Aftercare only | $70.79 | $102.33 | $169.82 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $102.33 Typical High $169.82 | Professional | 56 · Pre-op care only | $70.79 | $102.33 | $169.82 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $2,238.72 Typical High $3,235.94 | Facility | None | $676.08 | $2,238.72 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $1,288.25 Median $1,819.70 Typical High $2,041.74 | Professional | None | $1,288.25 | $1,819.70 | $2,041.74 |
United Setting Facility Modifier None Typical Low $933.25 Median $3,548.13 Typical High $10,232.93 | Facility | None | $933.25 | $3,548.13 | $10,232.93 |
United Setting Professional Modifier None Typical Low $891.25 Median $1,230.27 Typical High $1,737.80 | Professional | None | $891.25 | $1,230.27 | $1,737.80 |
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 $645.65 Median $645.65 Typical High $645.65 | Professional | 52 · Reduced service | $645.65 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $257.04 Typical High $257.04 | Professional | 53 · Discontinued | $257.04 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $912.01 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $912.01 | $912.01 | $912.01 |
Where Rhode Island sits
The same service costs 5.9 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· 32nd of 51
$1,288
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.