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 $389.05 Median $389.05 Typical High $389.05 | Professional | None | $389.05 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $295.12 Typical High $295.12 | Professional | 54 · Surgery only | $295.12 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $58.88 Typical High $58.88 | Professional | 55 · Aftercare only | $58.88 | $58.88 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $38.90 Typical High $38.90 | Professional | 56 · Pre-op care only | $38.90 | $38.90 | $38.90 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $269.15 Median $354.81 Typical High $588.84 | Professional | None | $269.15 | $354.81 | $588.84 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $245.47 Typical High $398.11 | Professional | 54 · Surgery only | $169.82 | $245.47 | $398.11 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $30.20 Typical High $50.12 | Professional | 55 · Aftercare only | $21.38 | $30.20 | $50.12 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $30.20 Typical High $50.12 | Professional | 56 · Pre-op care only | $21.38 | $30.20 | $50.12 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $2,238.72 Typical High $3,235.94 | Facility | None | $676.08 | $2,238.72 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $512.86 Typical High $602.56 | Professional | None | $338.84 | $512.86 | $602.56 |
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 $263.03 Median $371.54 Typical High $512.86 | Professional | None | $263.03 | $371.54 | $512.86 |
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 $194.98 Median $194.98 Typical High $194.98 | Professional | 52 · Reduced service | $194.98 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $77.62 Typical High $77.62 | Professional | 53 · Discontinued | $77.62 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $275.42 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $275.42 | $275.42 | $275.42 |
Where Rhode Island sits
The same service costs 6.0 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
$389
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.