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 $1,380.38 Median $1,380.38 Typical High $1,380.38 | Professional | None | $1,380.38 | $1,380.38 | $1,380.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,023.29 Typical High $1,023.29 | Professional | 54 · Surgery only | $1,023.29 | $1,023.29 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $204.17 Typical High $204.17 | Professional | 55 · Aftercare only | $204.17 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | 56 · Pre-op care only | $138.04 | $138.04 | $138.04 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $891.25 Median $1,202.26 Typical High $1,737.80 | Professional | None | $891.25 | $1,202.26 | $1,737.80 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $707.95 Typical High $831.76 | Professional | 54 · Surgery only | $575.44 | $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 $83.18 Median $102.33 Typical High $120.23 | Professional | 56 · Pre-op care only | $83.18 | $102.33 | $120.23 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $6,165.95 Typical High $8,709.64 | Facility | None | $676.08 | $6,165.95 | $8,709.64 |
Cigna Setting Professional Modifier None Typical Low $1,479.11 Median $1,819.70 Typical High $2,041.74 | Professional | None | $1,479.11 | $1,819.70 | $2,041.74 |
United Setting Facility Modifier None Typical Low $1,023.29 Median $4,570.88 Typical High $12,882.50 | Facility | None | $1,023.29 | $4,570.88 | $12,882.50 |
United Setting Professional Modifier None Typical Low $851.14 Median $1,202.26 Typical High $1,905.46 | Professional | None | $851.14 | $1,202.26 | $1,905.46 |
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 $691.83 Median $691.83 Typical High $691.83 | Professional | 52 · Reduced service | $691.83 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $275.42 Typical High $275.42 | Professional | 53 · Discontinued | $275.42 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $954.99 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $954.99 | $954.99 | $954.99 |
Where Rhode Island sits
The same service costs 14.8 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
$1,380
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.