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 $199.53 Median $199.53 Typical High $199.53 | Professional | 55 · Aftercare only | $199.53 | $199.53 | $199.53 |
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 $1,148.15 Median $1,513.56 Typical High $2,511.89 | Professional | None | $1,148.15 | $1,513.56 | $2,511.89 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $1,000.00 Typical High $1,621.81 | Professional | 54 · Surgery only | $691.83 | $1,000.00 | $1,621.81 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $181.97 Typical High $295.12 | Professional | 55 · Aftercare only | $128.82 | $181.97 | $295.12 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $128.82 Typical High $213.80 | Professional | 56 · Pre-op care only | $91.20 | $128.82 | $213.80 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $3,981.07 Typical High $5,623.41 | Facility | None | $954.99 | $3,981.07 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $1,659.59 Median $2,137.96 Typical High $2,691.53 | Professional | None | $1,659.59 | $2,137.96 | $2,691.53 |
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 $1,047.13 Median $1,348.96 Typical High $2,238.72 | Professional | None | $1,047.13 | $1,348.96 | $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 $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 6.6 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· 40th of 51
$1,514
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.