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 $1,905.46 Median $1,905.46 Typical High $1,905.46 | Professional | None | $1,905.46 | $1,905.46 | $1,905.46 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,412.54 Median $1,412.54 Typical High $1,412.54 | Professional | 54 · Surgery only | $1,412.54 | $1,412.54 | $1,412.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $281.84 Median $281.84 Typical High $281.84 | Professional | 55 · Aftercare only | $281.84 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $190.55 Median $190.55 Typical High $190.55 | Professional | 56 · Pre-op care only | $190.55 | $190.55 | $190.55 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $1,380.38 Median $1,819.70 Typical High $2,630.27 | Professional | None | $1,380.38 | $1,819.70 | $2,630.27 |
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 $323.59 Typical High $380.19 | Professional | 55 · Aftercare only | $269.15 | $323.59 | $380.19 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $154.88 Typical High $181.97 | Professional | 56 · Pre-op care only | $128.82 | $154.88 | $181.97 |
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 $1,995.26 Median $2,691.53 Typical High $3,090.30 | Professional | None | $1,995.26 | $2,691.53 | $3,090.30 |
United Setting Facility Modifier None Typical Low $1,023.29 Median $4,570.88 Typical High $10,471.29 | Facility | None | $1,023.29 | $4,570.88 | $10,471.29 |
United Setting Professional Modifier None Typical Low $1,000.00 Median $1,348.96 Typical High $2,754.23 | Professional | None | $1,000.00 | $1,348.96 | $2,754.23 |
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 $954.99 Median $954.99 Typical High $954.99 | Professional | 52 · Reduced service | $954.99 | $954.99 | $954.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $380.19 Median $380.19 Typical High $380.19 | Professional | 53 · Discontinued | $380.19 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,318.26 Median $1,318.26 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $1,318.26 | $1,318.26 | $1,318.26 |
Where Rhode Island sits
The same service costs 8.5 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
$1,905
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.