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 $1,548.82 Median $1,548.82 Typical High $1,548.82 | Professional | None | $1,548.82 | $1,548.82 | $1,548.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,148.15 Typical High $1,148.15 | Professional | 54 · Surgery only | $1,148.15 | $1,148.15 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | 55 · Aftercare only | $229.09 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | 56 · Pre-op care only | $154.88 | $154.88 | $154.88 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $912.01 Median $1,202.26 Typical High $1,995.26 | Professional | None | $912.01 | $1,202.26 | $1,995.26 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $707.95 Typical High $831.76 | Professional | 54 · Surgery only | $588.84 | $707.95 | $831.76 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $213.80 Typical High $251.19 | Professional | 55 · Aftercare only | $177.83 | $213.80 | $251.19 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $102.33 Typical High $120.23 | Professional | 56 · Pre-op care only | $85.11 | $102.33 | $120.23 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $3,981.07 Typical High $5,623.41 | Facility | None | $676.08 | $3,981.07 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $1,584.89 Median $1,819.70 Typical High $2,137.96 | Professional | None | $1,584.89 | $1,819.70 | $2,137.96 |
United Setting Facility Modifier None Typical Low $870.96 Median $2,089.30 Typical High $7,413.10 | Facility | None | $870.96 | $2,089.30 | $7,413.10 |
United Setting Professional Modifier None Typical Low $912.01 Median $1,258.93 Typical High $2,089.30 | Professional | None | $912.01 | $1,258.93 | $2,089.30 |
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 $758.58 Median $758.58 Typical High $758.58 | Professional | 52 · Reduced service | $758.58 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $309.03 Median $309.03 Typical High $309.03 | Professional | 53 · Discontinued | $309.03 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,071.52 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,071.52 | $1,071.52 |
Where Rhode Island sits
The same service costs 7.9 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· 23rd of 51
$1,549
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.