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 $2,089.30 Median $2,754.23 Typical High $3,981.07 | Facility | None | $2,089.30 | $2,754.23 | $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 $1,445.44 Median $1,445.44 Typical High $1,445.44 | Professional | 54 · Surgery only | $1,445.44 | $1,445.44 | $1,445.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $288.40 Median $288.40 Typical High $288.40 | Professional | 55 · Aftercare only | $288.40 | $288.40 | $288.40 |
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 $1,548.82 Median $2,041.74 Typical High $3,548.13 | Professional | None | $1,548.82 | $2,041.74 | $3,548.13 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $1,318.26 Typical High $2,290.87 | Professional | 54 · Surgery only | $933.25 | $1,318.26 | $2,290.87 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $245.47 Typical High $416.87 | Professional | 55 · Aftercare only | $173.78 | $245.47 | $416.87 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $173.78 Typical High $302.00 | Professional | 56 · Pre-op care only | $123.03 | $173.78 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $3,981.07 Typical High $5,623.41 | Facility | None | $588.84 | $3,981.07 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $2,238.72 Median $2,884.03 Typical High $3,630.78 | Professional | None | $2,238.72 | $2,884.03 | $3,630.78 |
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 $1,862.09 Typical High $3,090.30 | Professional | None | $1,412.54 | $1,862.09 | $3,090.30 |
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 $1,348.96 Median $1,348.96 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $1,348.96 | $1,348.96 | $1,348.96 |
Where Rhode Island sits
The same service costs 7.1 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· 36th of 51
$2,042
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.