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 $1,949.84 Median $1,949.84 Typical High $1,949.84 | Professional | None | $1,949.84 | $1,949.84 | $1,949.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,479.11 Median $1,479.11 Typical High $1,479.11 | Professional | 54 · Surgery only | $1,479.11 | $1,479.11 | $1,479.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $295.12 Median $295.12 Typical High $295.12 | Professional | 55 · Aftercare only | $295.12 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $194.98 Median $194.98 Typical High $194.98 | Professional | 56 · Pre-op care only | $194.98 | $194.98 | $194.98 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $1,584.89 Median $2,089.30 Typical High $2,884.03 | Professional | None | $1,584.89 | $2,089.30 | $2,884.03 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,230.27 Typical High $1,445.44 | Professional | 54 · Surgery only | $1,023.29 | $1,230.27 | $1,445.44 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $309.03 Median $371.54 Typical High $436.52 | Professional | 55 · Aftercare only | $309.03 | $371.54 | $436.52 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $177.83 Typical High $208.93 | Professional | 56 · Pre-op care only | $147.91 | $177.83 | $208.93 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $4,786.30 Typical High $6,918.31 | Facility | None | $676.08 | $4,786.30 | $6,918.31 |
Cigna Setting Professional Modifier None Typical Low $2,290.87 Median $3,090.30 Typical High $3,090.30 | Professional | None | $2,290.87 | $3,090.30 | $3,090.30 |
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 $1,412.54 Median $1,621.81 Typical High $3,235.94 | Professional | None | $1,412.54 | $1,621.81 | $3,235.94 |
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 $977.24 Median $977.24 Typical High $977.24 | Professional | 52 · Reduced service | $977.24 | $977.24 | $977.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $389.05 Median $389.05 Typical High $389.05 | Professional | 53 · Discontinued | $389.05 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,380.38 Median $1,380.38 Typical High $1,380.38 | Professional | 78 · Unplanned return to OR | $1,380.38 | $1,380.38 | $1,380.38 |
Where Rhode Island sits
The same service costs 11.2 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· 29th of 51
$2,089
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.