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 $1,778.28 Median $1,778.28 Typical High $1,778.28 | Professional | None | $1,778.28 | $1,778.28 | $1,778.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,318.26 Median $1,318.26 Typical High $1,318.26 | Professional | 54 · Surgery only | $1,318.26 | $1,318.26 | $1,318.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $263.03 Median $263.03 Typical High $263.03 | Professional | 55 · Aftercare only | $263.03 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $177.83 Median $177.83 Typical High $177.83 | Professional | 56 · Pre-op care only | $177.83 | $177.83 | $177.83 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $1,380.38 Median $1,862.09 Typical High $2,570.40 | Professional | None | $1,380.38 | $1,862.09 | $2,570.40 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $1,071.52 Typical High $1,258.93 | Professional | 54 · Surgery only | $891.25 | $1,071.52 | $1,258.93 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $269.15 Median $331.13 Typical High $389.05 | Professional | 55 · Aftercare only | $269.15 | $331.13 | $389.05 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $154.88 Typical High $186.21 | Professional | 56 · Pre-op care only | $128.82 | $154.88 | $186.21 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $2,137.96 Typical High $3,090.30 | Facility | None | $954.99 | $2,137.96 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $2,041.74 Median $2,754.23 Typical High $3,019.95 | Professional | None | $2,041.74 | $2,754.23 | $3,019.95 |
United Setting Facility Modifier None Typical Low $645.65 Median $1,445.44 Typical High $5,754.40 | Facility | None | $645.65 | $1,445.44 | $5,754.40 |
United Setting Professional Modifier None Typical Low $1,258.93 Median $1,513.56 Typical High $2,818.38 | Professional | None | $1,258.93 | $1,513.56 | $2,818.38 |
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 $891.25 Median $891.25 Typical High $891.25 | Professional | 52 · Reduced service | $891.25 | $891.25 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $354.81 Median $354.81 Typical High $354.81 | Professional | 53 · Discontinued | $354.81 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $1,230.27 | $1,230.27 | $1,230.27 |
Where Rhode Island sits
The same service costs 15.8 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· 27th of 51
$1,862
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.