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 $3,715.35 Typical High $3,981.07 | Facility | None | $3,715.35 | $3,715.35 | $3,981.07 |
Aetna Setting Professional Modifier None Typical Low $3,467.37 Median $3,467.37 Typical High $3,467.37 | Professional | None | $3,467.37 | $3,467.37 | $3,467.37 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,630.27 Median $2,630.27 Typical High $2,630.27 | Professional | 54 · Surgery only | $2,630.27 | $2,630.27 | $2,630.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $524.81 Median $524.81 Typical High $524.81 | Professional | 55 · Aftercare only | $524.81 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $346.74 Median $346.74 Typical High $346.74 | Professional | 56 · Pre-op care only | $346.74 | $346.74 | $346.74 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $3,981.07 Median $5,248.07 Typical High $9,332.54 | Professional | None | $3,981.07 | $5,248.07 | $9,332.54 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $2,398.83 Median $3,388.44 Typical High $6,025.60 | Professional | 54 · Surgery only | $2,398.83 | $3,388.44 | $6,025.60 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $436.52 Median $630.96 Typical High $1,122.02 | Professional | 55 · Aftercare only | $436.52 | $630.96 | $1,122.02 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $316.23 Median $446.68 Typical High $794.33 | Professional | 56 · Pre-op care only | $316.23 | $446.68 | $794.33 |
United Setting Facility Modifier None Typical Low $426.58 Median $1,513.56 Typical High $6,456.54 | Facility | None | $426.58 | $1,513.56 | $6,456.54 |
United Setting Professional Modifier None Typical Low $3,311.31 Median $3,890.45 Typical High $8,128.31 | Professional | None | $3,311.31 | $3,890.45 | $8,128.31 |
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 $1,737.80 Median $1,737.80 Typical High $1,737.80 | Professional | 52 · Reduced service | $1,737.80 | $1,737.80 | $1,737.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $691.83 Median $691.83 Typical High $691.83 | Professional | 53 · Discontinued | $691.83 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,454.71 Median $2,454.71 Typical High $2,454.71 | Professional | 78 · Unplanned return to OR | $2,454.71 | $2,454.71 | $2,454.71 |
Where Rhode Island sits
The same service costs 24.0 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· 43rd of 51
$3,981
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.