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 $3,019.95 Median $3,715.35 Typical High $3,981.07 | Facility | None | $3,019.95 | $3,715.35 | $3,981.07 |
Aetna Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $933.25 | Professional | None | $933.25 | $933.25 | $933.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $707.95 Typical High $707.95 | Professional | 54 · Surgery only | $707.95 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $141.25 Typical High $141.25 | Professional | 55 · Aftercare only | $141.25 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $93.33 Typical High $93.33 | Professional | 56 · Pre-op care only | $93.33 | $93.33 | $93.33 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $660.69 Median $891.25 Typical High $1,445.44 | Professional | None | $660.69 | $891.25 | $1,445.44 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $602.56 Typical High $1,000.00 | Professional | 54 · Surgery only | $416.87 | $602.56 | $1,000.00 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $75.86 Typical High $123.03 | Professional | 55 · Aftercare only | $52.48 | $75.86 | $123.03 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $75.86 Typical High $123.03 | Professional | 56 · Pre-op care only | $52.48 | $75.86 | $123.03 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $2,290.87 Typical High $3,235.94 | Facility | None | $676.08 | $2,290.87 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $954.99 Median $1,318.26 Typical High $1,513.56 | Professional | None | $954.99 | $1,318.26 | $1,513.56 |
United Setting Facility Modifier None Typical Low $812.83 Median $2,630.27 Typical High $7,943.28 | Facility | None | $812.83 | $2,630.27 | $7,943.28 |
United Setting Professional Modifier None Typical Low $645.65 Median $870.96 Typical High $1,258.93 | Professional | None | $645.65 | $870.96 | $1,258.93 |
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 $467.74 Median $467.74 Typical High $467.74 | Professional | 52 · Reduced service | $467.74 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $186.21 Typical High $186.21 | Professional | 53 · Discontinued | $186.21 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $660.69 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $660.69 | $660.69 | $660.69 |
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· 35th of 51
$933
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.