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 $1,288.25 | Professional | None | $1,288.25 | $1,288.25 | $1,288.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $954.99 Typical High $954.99 | Professional | 54 · Surgery only | $954.99 | $954.99 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $190.55 Typical High $190.55 | Professional | 55 · Aftercare only | $190.55 | $190.55 | $190.55 |
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 $870.96 Median $1,174.90 Typical High $2,041.74 | Professional | None | $870.96 | $1,174.90 | $2,041.74 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $794.33 Typical High $1,380.38 | Professional | 54 · Surgery only | $549.54 | $794.33 | $1,380.38 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $100.00 Typical High $173.78 | Professional | 55 · Aftercare only | $69.18 | $100.00 | $173.78 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $100.00 Typical High $173.78 | Professional | 56 · Pre-op care only | $69.18 | $100.00 | $173.78 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $6,456.54 Typical High $9,332.54 | Facility | None | $676.08 | $6,456.54 | $9,332.54 |
Cigna Setting Professional Modifier None Typical Low $1,258.93 Median $1,778.28 Typical High $1,995.26 | Professional | None | $1,258.93 | $1,778.28 | $1,995.26 |
United Setting Facility Modifier None Typical Low $812.83 Median $2,630.27 Typical High $9,549.93 | Facility | None | $812.83 | $2,630.27 | $9,549.93 |
United Setting Professional Modifier None Typical Low $870.96 Median $1,230.27 Typical High $1,698.24 | Professional | None | $870.96 | $1,230.27 | $1,698.24 |
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 $891.25 Median $891.25 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $891.25 | $891.25 | $891.25 |
Where Rhode Island sits
The same service costs 6.3 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.