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 $2,398.83 Median $3,235.94 Typical High $3,981.07 | Facility | None | $2,398.83 | $3,235.94 | $3,981.07 |
Aetna Setting Professional Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $1,621.81 | Professional | None | $1,621.81 | $1,621.81 | $1,621.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Professional | 54 · Surgery only | $1,230.27 | $1,230.27 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $245.47 Median $245.47 Typical High $245.47 | Professional | 55 · Aftercare only | $245.47 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | 56 · Pre-op care only | $162.18 | $162.18 | $162.18 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $1,202.26 Median $1,621.81 Typical High $2,344.23 | Professional | None | $1,202.26 | $1,621.81 | $2,344.23 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $933.25 Typical High $1,096.48 | Professional | 54 · Surgery only | $776.25 | $933.25 | $1,096.48 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $234.42 Median $288.40 Typical High $338.84 | Professional | 55 · Aftercare only | $234.42 | $288.40 | $338.84 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $134.90 Typical High $162.18 | Professional | 56 · Pre-op care only | $112.20 | $134.90 | $162.18 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $6,456.54 Typical High $9,332.54 | Facility | None | $676.08 | $6,456.54 | $9,332.54 |
Cigna Setting Professional Modifier None Typical Low $1,778.28 Median $2,398.83 Typical High $2,754.23 | Professional | None | $1,778.28 | $2,398.83 | $2,754.23 |
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 $758.58 Median $1,174.90 Typical High $2,398.83 | Professional | None | $758.58 | $1,174.90 | $2,398.83 |
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 $812.83 Median $812.83 Typical High $812.83 | Professional | 52 · Reduced service | $812.83 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $323.59 Median $323.59 Typical High $323.59 | Professional | 53 · Discontinued | $323.59 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,148.15 Median $1,148.15 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $1,148.15 | $1,148.15 | $1,148.15 |
Where Rhode Island sits
The same service costs 8.9 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
$1,622
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.