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 $3,981.07 Typical High $5,495.41 | Facility | None | $3,715.35 | $3,981.07 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $2,137.96 | Professional | None | $2,137.96 | $2,137.96 | $2,137.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,584.89 Median $1,584.89 Typical High $1,584.89 | Professional | 54 · Surgery only | $1,584.89 | $1,584.89 | $1,584.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $316.23 Median $316.23 Typical High $316.23 | Professional | 55 · Aftercare only | $316.23 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $213.80 Median $213.80 Typical High $213.80 | Professional | 56 · Pre-op care only | $213.80 | $213.80 | $213.80 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $1,445.44 Median $1,905.46 Typical High $2,884.03 | Professional | None | $1,445.44 | $1,905.46 | $2,884.03 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $1,122.02 Typical High $1,318.26 | Professional | 54 · Surgery only | $912.01 | $1,122.02 | $1,318.26 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $281.84 Median $338.84 Typical High $398.11 | Professional | 55 · Aftercare only | $281.84 | $338.84 | $398.11 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $162.18 Typical High $190.55 | Professional | 56 · Pre-op care only | $134.90 | $162.18 | $190.55 |
Cigna Setting Facility Modifier None Typical Low $1,318.26 Median $6,606.93 Typical High $9,549.93 | Facility | None | $1,318.26 | $6,606.93 | $9,549.93 |
Cigna Setting Professional Modifier None Typical Low $2,290.87 Median $2,884.03 Typical High $3,311.31 | Professional | None | $2,290.87 | $2,884.03 | $3,311.31 |
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 $1,318.26 Median $1,737.80 Typical High $3,019.95 | Professional | None | $1,318.26 | $1,737.80 | $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 $1,071.52 Median $1,071.52 Typical High $1,071.52 | Professional | 52 · Reduced service | $1,071.52 | $1,071.52 | $1,071.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $426.58 Median $426.58 Typical High $426.58 | Professional | 53 · Discontinued | $426.58 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,479.11 Median $1,479.11 Typical High $1,479.11 | Professional | 78 · Unplanned return to OR | $1,479.11 | $1,479.11 | $1,479.11 |
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· 26th of 51
$2,138
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.