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 $1,479.11 Median $1,479.11 Typical High $1,778.28 | Professional | None | $1,479.11 | $1,479.11 | $1,778.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,122.02 Typical High $1,318.26 | Professional | 54 · Surgery only | $1,122.02 | $1,122.02 | $1,318.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $223.87 Typical High $263.03 | Professional | 55 · Aftercare only | $223.87 | $223.87 | $263.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $147.91 Typical High $177.83 | Professional | 56 · Pre-op care only | $147.91 | $147.91 | $177.83 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $1,348.96 Median $1,737.80 Typical High $2,344.23 | Professional | None | $1,348.96 | $1,737.80 | $2,344.23 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $1,288.25 Typical High $1,819.70 | Professional | 54 · Surgery only | $891.25 | $1,288.25 | $1,819.70 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $158.49 Typical High $223.87 | Professional | 55 · Aftercare only | $112.20 | $158.49 | $223.87 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $141.25 Typical High $199.53 | Professional | 56 · Pre-op care only | $100.00 | $141.25 | $199.53 |
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 $1,621.81 Median $1,995.26 Typical High $2,754.23 | Professional | None | $1,621.81 | $1,995.26 | $2,754.23 |
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 $1,071.52 Median $1,479.11 Typical High $2,511.89 | Professional | None | $1,071.52 | $1,479.11 | $2,511.89 |
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 $741.31 Median $741.31 Typical High $891.25 | Professional | 52 · Reduced service | $741.31 | $741.31 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $295.12 Typical High $354.81 | Professional | 53 · Discontinued | $295.12 | $295.12 | $354.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,047.13 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,047.13 | $1,230.27 |
Where Rhode Island sits
The same service costs 5.2 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· 26th of 51
$1,778
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.