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 $954.99 Median $1,047.13 Typical High $1,047.13 | Professional | None | $954.99 | $1,047.13 | $1,047.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $776.25 Typical High $776.25 | Professional | 54 · Surgery only | $724.44 | $776.25 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $158.49 Typical High $158.49 | Professional | 55 · Aftercare only | $144.54 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $104.71 Typical High $104.71 | Professional | 56 · Pre-op care only | $95.50 | $104.71 | $104.71 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $977.24 Median $1,148.15 Typical High $1,621.81 | Professional | None | $977.24 | $1,148.15 | $1,621.81 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $812.83 Typical High $1,000.00 | Professional | 54 · Surgery only | $562.34 | $812.83 | $1,000.00 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $229.09 Typical High $281.84 | Professional | 55 · Aftercare only | $162.18 | $229.09 | $281.84 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $114.82 Typical High $141.25 | Professional | 56 · Pre-op care only | $81.28 | $114.82 | $141.25 |
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 $977.24 Median $1,778.28 Typical High $1,778.28 | Professional | None | $977.24 | $1,778.28 | $1,778.28 |
United Setting Facility Modifier None Typical Low $97.72 Median $316.23 Typical High $5,128.61 | Facility | None | $97.72 | $316.23 | $5,128.61 |
United Setting Professional Modifier None Typical Low $776.25 Median $912.01 Typical High $1,513.56 | Professional | None | $776.25 | $912.01 | $1,513.56 |
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 $478.63 Median $524.81 Typical High $524.81 | Professional | 52 · Reduced service | $478.63 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $208.93 Typical High $208.93 | Professional | 53 · Discontinued | $190.55 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $724.44 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $676.08 | $724.44 | $724.44 |
Where Rhode Island sits
The same service costs 7.2 times more in Alaska 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· 29th of 51
$1,148
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.