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 $2,398.83 Median $3,235.94 Typical High $3,981.07 | Facility | None | $2,398.83 | $3,235.94 | $3,981.07 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $562.34 | Professional | None | $562.34 | $562.34 | $562.34 |
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 $524.81 Typical High $851.14 | Professional | None | $398.11 | $524.81 | $851.14 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $331.13 Typical High $537.03 | Professional | 54 · Surgery only | $234.42 | $331.13 | $537.03 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $63.10 Typical High $100.00 | Professional | 55 · Aftercare only | $43.65 | $63.10 | $100.00 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $53.70 Typical High $87.10 | Professional | 56 · Pre-op care only | $38.02 | $53.70 | $87.10 |
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 $501.19 Median $758.58 Typical High $891.25 | Professional | None | $501.19 | $758.58 | $891.25 |
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 $380.19 Median $512.86 Typical High $741.31 | Professional | None | $380.19 | $512.86 | $741.31 |
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 10.2 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· 33rd 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.