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 $1,584.89 Median $1,584.89 Typical High $1,584.89 | Professional | None | $1,584.89 | $1,584.89 | $1,584.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $1,202.26 Typical High $1,202.26 | Professional | 54 · Surgery only | $1,202.26 | $1,202.26 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $239.88 Typical High $239.88 | Professional | 55 · Aftercare only | $239.88 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $158.49 Median $158.49 Typical High $158.49 | Professional | 56 · Pre-op care only | $158.49 | $158.49 | $158.49 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $1,071.52 Median $1,412.54 Typical High $2,041.74 | Professional | None | $1,071.52 | $1,412.54 | $2,041.74 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $831.76 Typical High $977.24 | Professional | 54 · Surgery only | $676.08 | $831.76 | $977.24 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $251.19 Typical High $295.12 | Professional | 55 · Aftercare only | $208.93 | $251.19 | $295.12 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $120.23 Typical High $141.25 | Professional | 56 · Pre-op care only | $100.00 | $120.23 | $141.25 |
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 $1,862.09 Median $2,089.30 Typical High $2,454.71 | Professional | None | $1,862.09 | $2,089.30 | $2,454.71 |
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 $977.24 Median $1,412.54 Typical High $2,238.72 | Professional | None | $977.24 | $1,412.54 | $2,238.72 |
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 $794.33 Median $794.33 Typical High $794.33 | Professional | 52 · Reduced service | $794.33 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $316.23 Median $316.23 Typical High $316.23 | Professional | 53 · Discontinued | $316.23 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,122.02 Median $1,122.02 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $1,122.02 | $1,122.02 | $1,122.02 |
Where Rhode Island sits
The same service costs 8.7 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
$1,585
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.