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 $2,884.03 Median $2,884.03 Typical High $2,884.03 | Professional | None | $2,884.03 | $2,884.03 | $2,884.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,137.96 Median $2,137.96 Typical High $2,137.96 | Professional | 54 · Surgery only | $2,137.96 | $2,137.96 | $2,137.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $426.58 Median $426.58 Typical High $426.58 | Professional | 55 · Aftercare only | $426.58 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $288.40 Median $288.40 Typical High $288.40 | Professional | 56 · Pre-op care only | $288.40 | $288.40 | $288.40 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $1,905.46 Median $2,570.40 Typical High $3,715.35 | Professional | None | $1,905.46 | $2,570.40 | $3,715.35 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $1,348.96 Median $1,659.59 Typical High $1,949.84 | Professional | 54 · Surgery only | $1,348.96 | $1,659.59 | $1,949.84 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $281.84 Typical High $331.13 | Professional | 55 · Aftercare only | $229.09 | $281.84 | $331.13 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $194.98 Median $239.88 Typical High $281.84 | Professional | 56 · Pre-op care only | $194.98 | $239.88 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $12,022.64 Typical High $17,378.01 | Facility | None | $676.08 | $12,022.64 | $17,378.01 |
Cigna Setting Professional Modifier None Typical Low $3,090.30 Median $3,801.89 Typical High $4,365.16 | Professional | None | $3,090.30 | $3,801.89 | $4,365.16 |
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 $1,778.28 Median $2,511.89 Typical High $4,073.80 | Professional | None | $1,778.28 | $2,511.89 | $4,073.80 |
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 $1,445.44 Median $1,445.44 Typical High $1,445.44 | Professional | 52 · Reduced service | $1,445.44 | $1,445.44 | $1,445.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $575.44 Median $575.44 Typical High $575.44 | Professional | 53 · Discontinued | $575.44 | $575.44 | $575.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,995.26 Median $1,995.26 Typical High $1,995.26 | Professional | 78 · Unplanned return to OR | $1,995.26 | $1,995.26 | $1,995.26 |
Where Rhode Island sits
The same service costs 6.5 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
$2,884
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.