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 Professional Modifier None Typical Low $2,041.74 Median $2,137.96 Typical High $2,454.71 | Professional | None | $2,041.74 | $2,137.96 | $2,454.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $302.00 Median $316.23 Typical High $363.08 | Professional | 55 · Aftercare only | $302.00 | $316.23 | $363.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $204.17 Median $213.80 Typical High $245.47 | Professional | 56 · Pre-op care only | $204.17 | $213.80 | $245.47 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $1,348.96 Median $1,698.24 Typical High $3,162.28 | Professional | None | $1,348.96 | $1,698.24 | $3,162.28 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $1,047.13 Typical High $1,380.38 | Professional | 54 · Surgery only | $758.58 | $1,047.13 | $1,380.38 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $234.42 Median $316.23 Typical High $426.58 | Professional | 55 · Aftercare only | $234.42 | $316.23 | $426.58 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $151.36 Typical High $204.17 | Professional | 56 · Pre-op care only | $112.20 | $151.36 | $204.17 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $1,148.15 Typical High $1,548.82 | Facility | None | $676.08 | $1,148.15 | $1,548.82 |
Cigna Setting Professional Modifier None Typical Low $2,344.23 Median $2,951.21 Typical High $2,951.21 | Professional | None | $2,344.23 | $2,951.21 | $2,951.21 |
United Setting Facility Modifier None Typical Low $933.25 Median $3,548.13 Typical High $10,232.93 | Facility | None | $933.25 | $3,548.13 | $10,232.93 |
United Setting Professional Modifier None Typical Low $1,202.26 Median $1,949.84 Typical High $3,090.30 | Professional | None | $1,202.26 | $1,949.84 | $3,090.30 |
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 $1,023.29 Median $1,047.13 Typical High $1,202.26 | Professional | 52 · Reduced service | $1,023.29 | $1,047.13 | $1,202.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $407.38 Median $426.58 Typical High $489.78 | Professional | 53 · Discontinued | $407.38 | $426.58 | $489.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,412.54 Median $1,479.11 Typical High $1,698.24 | Professional | 78 · Unplanned return to OR | $1,412.54 | $1,479.11 | $1,698.24 |
Where Rhode Island sits
The same service costs 5.1 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· 23rd of 51
$2,089
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.