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 $562.34 Median $562.34 Typical High $660.69 | Professional | None | $562.34 | $562.34 | $660.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $426.58 Typical High $426.58 | Professional | 54 · Surgery only | $426.58 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $85.11 Typical High $85.11 | Professional | 55 · Aftercare only | $85.11 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $56.23 Typical High $56.23 | Professional | 56 · Pre-op care only | $56.23 | $56.23 | $56.23 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $398.11 Median $537.03 Typical High $891.25 | Professional | None | $398.11 | $537.03 | $891.25 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $363.08 Typical High $602.56 | Professional | 54 · Surgery only | $257.04 | $363.08 | $602.56 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $45.71 Typical High $75.86 | Professional | 55 · Aftercare only | $31.62 | $45.71 | $75.86 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $45.71 Typical High $75.86 | Professional | 56 · Pre-op care only | $31.62 | $45.71 | $75.86 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $4,365.16 Typical High $6,309.57 | Facility | None | $831.76 | $4,365.16 | $6,309.57 |
Cigna Setting Professional Modifier None Typical Low $549.54 Median $812.83 Typical High $912.01 | Professional | None | $549.54 | $812.83 | $912.01 |
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 $389.05 Median $501.19 Typical High $776.25 | Professional | None | $389.05 | $501.19 | $776.25 |
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 $281.84 Median $281.84 Typical High $281.84 | Professional | 52 · Reduced service | $281.84 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $112.20 Typical High $112.20 | Professional | 53 · Discontinued | $112.20 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $398.11 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $398.11 | $398.11 | $398.11 |
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· 39th of 51
$562
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.