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 $1,698.24 Median $1,698.24 Typical High $1,698.24 | Professional | None | $1,698.24 | $1,698.24 | $1,698.24 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,288.25 Median $1,288.25 Typical High $1,288.25 | Professional | 54 · Surgery only | $1,288.25 | $1,288.25 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $257.04 Typical High $257.04 | Professional | 55 · Aftercare only | $257.04 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $169.82 Median $169.82 Typical High $169.82 | Professional | 56 · Pre-op care only | $169.82 | $169.82 | $169.82 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $1,258.93 Median $1,698.24 Typical High $2,290.87 | Professional | None | $1,258.93 | $1,698.24 | $2,290.87 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $977.24 Typical High $1,148.15 | Professional | 54 · Surgery only | $812.83 | $977.24 | $1,148.15 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $245.47 Median $302.00 Typical High $354.81 | Professional | 55 · Aftercare only | $245.47 | $302.00 | $354.81 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $141.25 Typical High $169.82 | Professional | 56 · Pre-op care only | $117.49 | $141.25 | $169.82 |
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 $1,862.09 Median $2,511.89 Typical High $2,630.27 | Professional | None | $1,862.09 | $2,511.89 | $2,630.27 |
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 $1,148.15 Median $1,412.54 Typical High $2,630.27 | Professional | None | $1,148.15 | $1,412.54 | $2,630.27 |
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 $851.14 Median $851.14 Typical High $851.14 | Professional | 52 · Reduced service | $851.14 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $338.84 Median $338.84 Typical High $338.84 | Professional | 53 · Discontinued | $338.84 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,202.26 Median $1,202.26 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $1,202.26 | $1,202.26 | $1,202.26 |
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· 31st of 51
$1,698
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.