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 $1,513.56 Median $1,548.82 Typical High $3,981.07 | Facility | None | $1,513.56 | $1,548.82 | $3,981.07 |
Aetna Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $436.52 | Professional | None | $436.52 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $323.59 Typical High $323.59 | Professional | 54 · Surgery only | $323.59 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $66.07 Typical High $66.07 | Professional | 55 · Aftercare only | $66.07 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $43.65 Typical High $43.65 | Professional | 56 · Pre-op care only | $43.65 | $43.65 | $43.65 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $331.13 Median $446.68 Typical High $645.65 | Professional | None | $331.13 | $446.68 | $645.65 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $275.42 Typical High $407.38 | Professional | 54 · Surgery only | $194.98 | $275.42 | $407.38 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $52.48 Typical High $77.62 | Professional | 55 · Aftercare only | $37.15 | $52.48 | $77.62 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $44.67 Typical High $66.07 | Professional | 56 · Pre-op care only | $31.62 | $44.67 | $66.07 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $2,238.72 Typical High $3,235.94 | Facility | None | $446.68 | $2,238.72 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $407.38 Median $630.96 Typical High $707.95 | Professional | None | $407.38 | $630.96 | $707.95 |
United Setting Facility Modifier None Typical Low $870.96 Median $2,089.30 Typical High $7,079.46 | Facility | None | $870.96 | $2,089.30 | $7,079.46 |
United Setting Professional Modifier None Typical Low $281.84 Median $380.19 Typical High $602.56 | Professional | None | $281.84 | $380.19 | $602.56 |
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 $218.78 Median $218.78 Typical High $218.78 | Professional | 52 · Reduced service | $218.78 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $87.10 Typical High $87.10 | Professional | 53 · Discontinued | $87.10 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $302.00 Median $302.00 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $302.00 | $302.00 | $302.00 |
Where Rhode Island sits
The same service costs 8.5 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
$447
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.