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 $3,715.35 Median $3,715.35 Typical High $3,981.07 | Facility | None | $3,715.35 | $3,715.35 | $3,981.07 |
Aetna Setting Professional Modifier None Typical Low $3,019.95 Median $3,019.95 Typical High $3,019.95 | Professional | None | $3,019.95 | $3,019.95 | $3,019.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,238.72 Median $2,238.72 Typical High $2,238.72 | Professional | 54 · Surgery only | $2,238.72 | $2,238.72 | $2,238.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $446.68 Median $446.68 Typical High $446.68 | Professional | 55 · Aftercare only | $446.68 | $446.68 | $446.68 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $302.00 Median $302.00 Typical High $302.00 | Professional | 56 · Pre-op care only | $302.00 | $302.00 | $302.00 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $2,454.71 Median $3,235.94 Typical High $4,466.84 | Professional | None | $2,454.71 | $3,235.94 | $4,466.84 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $1,584.89 Median $1,905.46 Typical High $2,238.72 | Professional | 54 · Surgery only | $1,584.89 | $1,905.46 | $2,238.72 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $478.63 Median $575.44 Typical High $676.08 | Professional | 55 · Aftercare only | $478.63 | $575.44 | $676.08 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $229.09 Median $275.42 Typical High $323.59 | Professional | 56 · Pre-op care only | $229.09 | $275.42 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $18,197.01 Typical High $26,302.68 | Facility | None | $676.08 | $18,197.01 | $26,302.68 |
Cigna Setting Professional Modifier None Typical Low $3,630.78 Median $4,897.79 Typical High $5,623.41 | Professional | None | $3,630.78 | $4,897.79 | $5,623.41 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $5,623.41 Typical High $19,054.61 | Facility | None | $1,230.27 | $5,623.41 | $19,054.61 |
United Setting Professional Modifier None Typical Low $2,238.72 Median $2,884.03 Typical High $5,011.87 | Professional | None | $2,238.72 | $2,884.03 | $5,011.87 |
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 $1,513.56 Median $1,513.56 Typical High $1,513.56 | Professional | 52 · Reduced service | $1,513.56 | $1,513.56 | $1,513.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $602.56 Median $602.56 Typical High $602.56 | Professional | 53 · Discontinued | $602.56 | $602.56 | $602.56 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,089.30 Median $2,089.30 Typical High $2,089.30 | Professional | 78 · Unplanned return to OR | $2,089.30 | $2,089.30 | $2,089.30 |
Where Rhode Island sits
The same service costs 20.0 times more in Alaska than in Texas. 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· 31st of 51
$3,236
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.