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 $3,548.13 Median $3,548.13 Typical High $3,548.13 | Professional | None | $3,548.13 | $3,548.13 | $3,548.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,630.27 Median $2,630.27 Typical High $2,630.27 | Professional | 54 · Surgery only | $2,630.27 | $2,630.27 | $2,630.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $524.81 Median $524.81 Typical High $524.81 | Professional | 55 · Aftercare only | $524.81 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $354.81 Median $354.81 Typical High $354.81 | Professional | 56 · Pre-op care only | $354.81 | $354.81 | $354.81 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $2,511.89 Median $3,311.31 Typical High $4,570.88 | Professional | None | $2,511.89 | $3,311.31 | $4,570.88 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $1,584.89 Median $1,949.84 Typical High $2,290.87 | Professional | 54 · Surgery only | $1,584.89 | $1,949.84 | $2,290.87 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $489.78 Median $588.84 Typical High $691.83 | Professional | 55 · Aftercare only | $489.78 | $588.84 | $691.83 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $234.42 Median $281.84 Typical High $331.13 | Professional | 56 · Pre-op care only | $234.42 | $281.84 | $331.13 |
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 $4,265.80 Median $5,011.87 Typical High $5,623.41 | Professional | None | $4,265.80 | $5,011.87 | $5,623.41 |
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 $2,290.87 Median $3,235.94 Typical High $5,248.07 | Professional | None | $2,290.87 | $3,235.94 | $5,248.07 |
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 $1,737.80 Median $1,737.80 Typical High $1,737.80 | Professional | 52 · Reduced service | $1,737.80 | $1,737.80 | $1,737.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $707.95 Median $707.95 Typical High $707.95 | Professional | 53 · Discontinued | $707.95 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,454.71 Median $2,454.71 Typical High $2,454.71 | Professional | 78 · Unplanned return to OR | $2,454.71 | $2,454.71 | $2,454.71 |
Where Rhode Island sits
The same service costs 20.9 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· 28th of 51
$3,548
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.