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 $1,318.26 Median $1,318.26 Typical High $1,318.26 | Professional | None | $1,318.26 | $1,318.26 | $1,318.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $977.24 Typical High $977.24 | Professional | 54 · Surgery only | $977.24 | $977.24 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $194.98 Typical High $194.98 | Professional | 55 · Aftercare only | $194.98 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $131.83 Typical High $131.83 | Professional | 56 · Pre-op care only | $131.83 | $131.83 | $131.83 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $912.01 Median $1,202.26 Typical High $1,698.24 | Professional | None | $912.01 | $1,202.26 | $1,698.24 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $707.95 Typical High $831.76 | Professional | 54 · Surgery only | $575.44 | $707.95 | $831.76 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $213.80 Typical High $251.19 | Professional | 55 · Aftercare only | $177.83 | $213.80 | $251.19 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $102.33 Typical High $120.23 | Professional | 56 · Pre-op care only | $85.11 | $102.33 | $120.23 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $8,912.51 Typical High $12,589.25 | Facility | None | $954.99 | $8,912.51 | $12,589.25 |
Cigna Setting Professional Modifier None Typical Low $1,445.44 Median $1,778.28 Typical High $2,041.74 | Professional | None | $1,445.44 | $1,778.28 | $2,041.74 |
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 $831.76 Median $1,122.02 Typical High $1,862.09 | Professional | None | $831.76 | $1,122.02 | $1,862.09 |
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 $660.69 Median $660.69 Typical High $660.69 | Professional | 52 · Reduced service | $660.69 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $263.03 Typical High $263.03 | Professional | 53 · Discontinued | $263.03 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $912.01 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $912.01 | $912.01 | $912.01 |
Where Rhode Island sits
The same service costs 8.5 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· 29th of 51
$1,318
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.