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 $1,071.52 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 $162.18 Median $162.18 Typical High $162.18 | Professional | 55 · Aftercare only | $162.18 | $162.18 | $162.18 |
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 $794.33 Median $1,047.13 Typical High $1,445.44 | Professional | None | $794.33 | $1,047.13 | $1,445.44 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $616.60 Typical High $724.44 | Professional | 54 · Surgery only | $501.19 | $616.60 | $724.44 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $186.21 Typical High $218.78 | Professional | 55 · Aftercare only | $154.88 | $186.21 | $218.78 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $89.13 Typical High $104.71 | Professional | 56 · Pre-op care only | $74.13 | $89.13 | $104.71 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $2,137.96 Typical High $3,090.30 | Facility | None | $676.08 | $2,137.96 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $1,318.26 Median $1,584.89 Typical High $1,659.59 | Professional | None | $1,318.26 | $1,584.89 | $1,659.59 |
United Setting Facility Modifier None Typical Low $870.96 Median $2,089.30 Typical High $7,244.36 | Facility | None | $870.96 | $2,089.30 | $7,244.36 |
United Setting Professional Modifier None Typical Low $691.83 Median $933.25 Typical High $1,584.89 | Professional | None | $691.83 | $933.25 | $1,584.89 |
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 8.3 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.