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 $83.18 Median $102.33 Typical High $114.82 | Professional | None | $83.18 | $102.33 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $63.10 Median $75.86 Typical High $75.86 | Professional | 54 · Surgery only | $63.10 | $75.86 | $75.86 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $70.79 Median $97.72 Typical High $154.88 | Professional | None | $70.79 | $97.72 | $154.88 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $46.77 Median $67.61 Typical High $91.20 | Professional | 54 · Surgery only | $46.77 | $67.61 | $91.20 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $5.89 Median $8.51 Typical High $11.48 | Professional | 55 · Aftercare only | $5.89 | $8.51 | $11.48 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $8.51 Typical High $11.48 | Professional | 56 · Pre-op care only | $5.89 | $8.51 | $11.48 |
Cigna Setting Facility Modifier None Typical Low $57.54 Median $77.62 Typical High $1,202.26 | Facility | None | $57.54 | $77.62 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $131.83 Typical High $154.88 | Professional | None | $112.20 | $131.83 | $154.88 |
United Setting Facility Modifier None Typical Low $97.72 Median $316.23 Typical High $3,890.45 | Facility | None | $97.72 | $316.23 | $3,890.45 |
United Setting Professional Modifier None Typical Low $58.88 Median $87.10 Typical High $151.36 | Professional | None | $58.88 | $87.10 | $151.36 |
1 more rate 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 78 · Unplanned return to OR Typical Low $58.88 Median $70.79 Typical High $70.79 | Professional | 78 · Unplanned return to OR | $58.88 | $70.79 | $70.79 |
Where Rhode Island sits
The same service costs 3.9 times more in Alaska than in Florida. 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· 24th of 51
$102
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.