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 $4,897.79 | Facility | None | $3,715.35 | $3,981.07 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $2,570.40 Median $2,570.40 Typical High $2,570.40 | Professional | None | $2,570.40 | $2,570.40 | $2,570.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,905.46 Median $1,905.46 Typical High $1,905.46 | Professional | 54 · Surgery only | $1,905.46 | $1,905.46 | $1,905.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $380.19 Median $380.19 Typical High $380.19 | Professional | 55 · Aftercare only | $380.19 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $257.04 Median $257.04 Typical High $257.04 | Professional | 56 · Pre-op care only | $257.04 | $257.04 | $257.04 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $1,737.80 Median $2,344.23 Typical High $3,311.31 | Professional | None | $1,737.80 | $2,344.23 | $3,311.31 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,380.38 Typical High $1,621.81 | Professional | 54 · Surgery only | $1,122.02 | $1,380.38 | $1,621.81 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $346.74 Median $416.87 Typical High $489.78 | Professional | 55 · Aftercare only | $346.74 | $416.87 | $489.78 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $162.18 Median $199.53 Typical High $234.42 | Professional | 56 · Pre-op care only | $162.18 | $199.53 | $234.42 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $12,302.69 Typical High $17,782.79 | Facility | None | $676.08 | $12,302.69 | $17,782.79 |
Cigna Setting Professional Modifier None Typical Low $2,570.40 Median $3,467.37 Typical High $3,981.07 | Professional | None | $2,570.40 | $3,467.37 | $3,981.07 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $5,623.41 Typical High $19,054.61 | Facility | None | $1,230.27 | $5,623.41 | $19,054.61 |
United Setting Professional Modifier None Typical Low $1,584.89 Median $2,089.30 Typical High $3,630.78 | Professional | None | $1,584.89 | $2,089.30 | $3,630.78 |
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 $1,288.25 Median $1,288.25 Typical High $1,288.25 | Professional | 52 · Reduced service | $1,288.25 | $1,288.25 | $1,288.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $512.86 Median $512.86 Typical High $512.86 | Professional | 53 · Discontinued | $512.86 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,778.28 Median $1,778.28 Typical High $1,778.28 | Professional | 78 · Unplanned return to OR | $1,778.28 | $1,778.28 | $1,778.28 |
Where Rhode Island sits
The same service costs 16.2 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· 26th of 51
$2,570
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.