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 $3,715.35 Median $3,981.07 Typical High $5,495.41 | Facility | None | $3,715.35 | $3,981.07 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $1,737.80 | Professional | None | $1,737.80 | $1,737.80 | $1,737.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,288.25 Median $1,288.25 Typical High $1,288.25 | Professional | 54 · Surgery only | $1,288.25 | $1,288.25 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $257.04 Typical High $257.04 | Professional | 55 · Aftercare only | $257.04 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | 56 · Pre-op care only | $173.78 | $173.78 | $173.78 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $1,412.54 Median $1,905.46 Typical High $3,235.94 | Professional | None | $1,412.54 | $1,905.46 | $3,235.94 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $1,230.27 Typical High $2,089.30 | Professional | 54 · Surgery only | $851.14 | $1,230.27 | $2,089.30 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $223.87 Typical High $380.19 | Professional | 55 · Aftercare only | $158.49 | $223.87 | $380.19 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $162.18 Typical High $269.15 | Professional | 56 · Pre-op care only | $112.20 | $162.18 | $269.15 |
Cigna Setting Facility Modifier None Typical Low $1,778.28 Median $3,981.07 Typical High $5,623.41 | Facility | None | $1,778.28 | $3,981.07 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $2,041.74 Median $2,691.53 Typical High $3,388.44 | Professional | None | $2,041.74 | $2,691.53 | $3,388.44 |
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 $1,412.54 Median $1,737.80 Typical High $2,818.38 | Professional | None | $1,412.54 | $1,737.80 | $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 $851.14 Median $851.14 Typical High $851.14 | Professional | 52 · Reduced service | $851.14 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $346.74 Median $346.74 Typical High $346.74 | Professional | 53 · Discontinued | $346.74 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,202.26 Median $1,202.26 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $1,202.26 | $1,202.26 | $1,202.26 |
Where Rhode Island sits
The same service costs 6.3 times more in Alaska than in Utah. 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· 38th 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.