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 $1,348.96 Median $1,348.96 Typical High $1,348.96 | Professional | None | $1,348.96 | $1,348.96 | $1,348.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,000.00 Typical High $1,000.00 | Professional | 54 · Surgery only | $1,000.00 | $1,000.00 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $204.17 Typical High $204.17 | Professional | 55 · Aftercare only | $204.17 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $134.90 Typical High $134.90 | Professional | 56 · Pre-op care only | $134.90 | $134.90 | $134.90 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $933.25 Median $1,258.93 Typical High $1,698.24 | Professional | None | $933.25 | $1,258.93 | $1,698.24 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $741.31 Typical High $870.96 | Professional | 54 · Surgery only | $602.56 | $741.31 | $870.96 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $223.87 Typical High $263.03 | Professional | 55 · Aftercare only | $186.21 | $223.87 | $263.03 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $107.15 Typical High $125.89 | Professional | 56 · Pre-op care only | $87.10 | $107.15 | $125.89 |
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 $1,380.38 Median $1,862.09 Typical High $2,041.74 | Professional | None | $1,380.38 | $1,862.09 | $2,041.74 |
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 $831.76 Median $1,071.52 Typical High $1,949.84 | Professional | None | $831.76 | $1,071.52 | $1,949.84 |
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 $676.08 Median $676.08 Typical High $676.08 | Professional | 52 · Reduced service | $676.08 | $676.08 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $269.15 Typical High $269.15 | Professional | 53 · Discontinued | $269.15 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $933.25 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $933.25 | $933.25 | $933.25 |
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· 24th of 51
$1,349
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.