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 $4,265.80 Median $4,265.80 Typical High $4,265.80 | Professional | None | $4,265.80 | $4,265.80 | $4,265.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3,162.28 Median $3,162.28 Typical High $3,162.28 | Professional | 54 · Surgery only | $3,162.28 | $3,162.28 | $3,162.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $630.96 Median $630.96 Typical High $630.96 | Professional | 55 · Aftercare only | $630.96 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $426.58 Median $426.58 Typical High $426.58 | Professional | 56 · Pre-op care only | $426.58 | $426.58 | $426.58 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $3,388.44 Median $4,466.84 Typical High $6,165.95 | Professional | None | $3,388.44 | $4,466.84 | $6,165.95 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $2,187.76 Median $2,630.27 Typical High $3,090.30 | Professional | 54 · Surgery only | $2,187.76 | $2,630.27 | $3,090.30 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $660.69 Median $812.83 Typical High $954.99 | Professional | 55 · Aftercare only | $660.69 | $812.83 | $954.99 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $316.23 Median $380.19 Typical High $446.68 | Professional | 56 · Pre-op care only | $316.23 | $380.19 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $6,165.95 Typical High $8,709.64 | Facility | None | $676.08 | $6,165.95 | $8,709.64 |
Cigna Setting Professional Modifier None Typical Low $5,495.41 Median $6,760.83 Typical High $6,760.83 | Professional | None | $5,495.41 | $6,760.83 | $6,760.83 |
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 $3,162.28 Median $4,168.69 Typical High $6,918.31 | Professional | None | $3,162.28 | $4,168.69 | $6,918.31 |
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 $2,137.96 Median $2,137.96 Typical High $2,137.96 | Professional | 52 · Reduced service | $2,137.96 | $2,137.96 | $2,137.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $851.14 Median $851.14 Typical High $851.14 | Professional | 53 · Discontinued | $851.14 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,951.21 Median $2,951.21 Typical High $2,951.21 | Professional | 78 · Unplanned return to OR | $2,951.21 | $2,951.21 | $2,951.21 |
Where Rhode Island sits
The same service costs 20.4 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· 28th of 51
$4,467
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.