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 $2,089.30 Median $2,754.23 Typical High $3,981.07 | Facility | None | $2,089.30 | $2,754.23 | $3,981.07 |
Aetna Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $234.42 | Professional | None | $234.42 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $177.83 Typical High $177.83 | Professional | 54 · Surgery only | $177.83 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $35.48 Typical High $35.48 | Professional | 55 · Aftercare only | $35.48 | $35.48 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $23.44 Typical High $23.44 | Professional | 56 · Pre-op care only | $23.44 | $23.44 | $23.44 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $169.82 Median $223.87 Typical High $363.08 | Professional | None | $169.82 | $223.87 | $363.08 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $151.36 Typical High $245.47 | Professional | 54 · Surgery only | $107.15 | $151.36 | $245.47 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $19.05 Typical High $30.90 | Professional | 55 · Aftercare only | $13.49 | $19.05 | $30.90 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $19.05 Typical High $30.90 | Professional | 56 · Pre-op care only | $13.49 | $19.05 | $30.90 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $1,621.81 Typical High $2,344.23 | Facility | None | $676.08 | $1,621.81 | $2,344.23 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $323.59 Typical High $371.54 | Professional | None | $213.80 | $323.59 | $371.54 |
United Setting Facility Modifier None Typical Low $645.65 Median $1,445.44 Typical High $5,754.40 | Facility | None | $645.65 | $1,445.44 | $5,754.40 |
United Setting Professional Modifier None Typical Low $162.18 Median $213.80 Typical High $316.23 | Professional | None | $162.18 | $213.80 | $316.23 |
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 $117.49 Median $117.49 Typical High $117.49 | Professional | 52 · Reduced service | $117.49 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $46.77 Typical High $46.77 | Professional | 53 · Discontinued | $46.77 | $46.77 | $46.77 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | 78 · Unplanned return to OR | $165.96 | $165.96 | $165.96 |
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· 36th of 51
$234
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.