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 $1,071.52 Median $1,071.52 Typical High $1,071.52 | Professional | None | $1,071.52 | $1,071.52 | $1,071.52 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $794.33 Typical High $794.33 | Professional | 54 · Surgery only | $794.33 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $158.49 Typical High $158.49 | Professional | 55 · Aftercare only | $158.49 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $107.15 Typical High $107.15 | Professional | 56 · Pre-op care only | $107.15 | $107.15 | $107.15 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $758.58 Median $1,000.00 Typical High $1,412.54 | Professional | None | $758.58 | $1,000.00 | $1,412.54 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $588.84 Typical High $691.83 | Professional | 54 · Surgery only | $489.78 | $588.84 | $691.83 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $177.83 Typical High $213.80 | Professional | 55 · Aftercare only | $147.91 | $177.83 | $213.80 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $85.11 Typical High $100.00 | Professional | 56 · Pre-op care only | $70.79 | $85.11 | $100.00 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $4,786.30 Typical High $6,918.31 | Facility | None | $831.76 | $4,786.30 | $6,918.31 |
Cigna Setting Professional Modifier None Typical Low $1,202.26 Median $1,479.11 Typical High $1,698.24 | Professional | None | $1,202.26 | $1,479.11 | $1,698.24 |
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 $676.08 Median $891.25 Typical High $1,548.82 | Professional | None | $676.08 | $891.25 | $1,548.82 |
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 $537.03 Median $537.03 Typical High $537.03 | Professional | 52 · Reduced service | $537.03 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $213.80 Typical High $213.80 | Professional | 53 · Discontinued | $213.80 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $741.31 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $741.31 | $741.31 | $741.31 |
Where Rhode Island sits
The same service costs 7.6 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
$1,072
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.