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 $3,467.37 Median $3,715.35 Typical High $3,981.07 | Facility | None | $3,467.37 | $3,715.35 | $3,981.07 |
Aetna Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,000.00 | Professional | None | $1,000.00 | $1,000.00 | $1,000.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $741.31 Typical High $741.31 | Professional | 54 · Surgery only | $741.31 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $147.91 Typical High $147.91 | Professional | 55 · Aftercare only | $147.91 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | 56 · Pre-op care only | $100.00 | $100.00 | $100.00 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $691.83 Median $912.01 Typical High $1,258.93 | Professional | None | $691.83 | $912.01 | $1,258.93 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $537.03 Typical High $630.96 | Professional | 54 · Surgery only | $446.68 | $537.03 | $630.96 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $162.18 Typical High $190.55 | Professional | 55 · Aftercare only | $134.90 | $162.18 | $190.55 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $77.62 Typical High $91.20 | Professional | 56 · Pre-op care only | $64.57 | $77.62 | $91.20 |
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 $1,096.48 Median $1,380.38 Typical High $1,445.44 | Professional | None | $1,096.48 | $1,380.38 | $1,445.44 |
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 $645.65 Median $831.76 Typical High $1,445.44 | Professional | None | $645.65 | $831.76 | $1,445.44 |
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 $489.78 Median $489.78 Typical High $489.78 | Professional | 52 · Reduced service | $489.78 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $199.53 Typical High $199.53 | Professional | 53 · Discontinued | $199.53 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $691.83 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $691.83 | $691.83 | $691.83 |
Where Rhode Island sits
The same service costs 16.6 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· 27th of 51
$1,000
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.