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 $3,019.95 Median $3,715.35 Typical High $3,981.07 | Facility | None | $3,019.95 | $3,715.35 | $3,981.07 |
Aetna Setting Professional Modifier None Typical Low $2,238.72 Median $2,238.72 Typical High $2,238.72 | Professional | None | $2,238.72 | $2,238.72 | $2,238.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,698.24 Median $1,698.24 Typical High $1,698.24 | Professional | 54 · Surgery only | $1,698.24 | $1,698.24 | $1,698.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $338.84 Median $338.84 Typical High $338.84 | Professional | 55 · Aftercare only | $338.84 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $223.87 Median $223.87 Typical High $223.87 | Professional | 56 · Pre-op care only | $223.87 | $223.87 | $223.87 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $1,445.44 Median $1,949.84 Typical High $3,019.95 | Professional | None | $1,445.44 | $1,949.84 | $3,019.95 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $1,122.02 Typical High $1,318.26 | Professional | 54 · Surgery only | $933.25 | $1,122.02 | $1,318.26 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $281.84 Median $346.74 Typical High $407.38 | Professional | 55 · Aftercare only | $281.84 | $346.74 | $407.38 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $162.18 Typical High $194.98 | Professional | 56 · Pre-op care only | $134.90 | $162.18 | $194.98 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $5,011.87 Typical High $7,079.46 | Facility | None | $676.08 | $5,011.87 | $7,079.46 |
Cigna Setting Professional Modifier None Typical Low $2,137.96 Median $2,884.03 Typical High $3,388.44 | Professional | None | $2,137.96 | $2,884.03 | $3,388.44 |
United Setting Facility Modifier None Typical Low $933.25 Median $3,548.13 Typical High $12,589.25 | Facility | None | $933.25 | $3,548.13 | $12,589.25 |
United Setting Professional Modifier None Typical Low $1,348.96 Median $1,698.24 Typical High $3,019.95 | Professional | None | $1,348.96 | $1,698.24 | $3,019.95 |
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 $1,122.02 Median $1,122.02 Typical High $1,122.02 | Professional | 52 · Reduced service | $1,122.02 | $1,122.02 | $1,122.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $446.68 Median $446.68 Typical High $446.68 | Professional | 53 · Discontinued | $446.68 | $446.68 | $446.68 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,584.89 Median $1,584.89 Typical High $1,584.89 | Professional | 78 · Unplanned return to OR | $1,584.89 | $1,584.89 | $1,584.89 |
Where Rhode Island sits
The same service costs 19.5 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· 24th of 51
$2,239
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.