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 $3,311.31 Median $3,548.13 Typical High $3,548.13 | Professional | None | $3,311.31 | $3,548.13 | $3,548.13 |
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 $354.81 Median $354.81 Typical High $354.81 | Professional | 56 · Pre-op care only | $354.81 | $354.81 | $354.81 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $3,090.30 Median $3,630.78 Typical High $3,630.78 | Professional | None | $3,090.30 | $3,630.78 | $3,630.78 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $1,737.80 Median $2,511.89 Typical High $2,951.21 | Professional | 54 · Surgery only | $1,737.80 | $2,511.89 | $2,951.21 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $309.03 Typical High $363.08 | Professional | 55 · Aftercare only | $218.78 | $309.03 | $363.08 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $194.98 Median $281.84 Typical High $331.13 | Professional | 56 · Pre-op care only | $194.98 | $281.84 | $331.13 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $676.08 Typical High $1,202.26 | Facility | None | $50.12 | $676.08 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $3,467.37 Median $4,570.88 Typical High $4,570.88 | Professional | None | $3,467.37 | $4,570.88 | $4,570.88 |
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 $2,511.89 Median $2,754.23 Typical High $4,168.69 | Professional | None | $2,511.89 | $2,754.23 | $4,168.69 |
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 $1,778.28 Median $1,778.28 Typical High $1,778.28 | Professional | 52 · Reduced service | $1,778.28 | $1,778.28 | $1,778.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $707.95 Median $707.95 Typical High $707.95 | Professional | 53 · Discontinued | $707.95 | $707.95 | $707.95 |
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 22.9 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· 23rd of 51
$3,548
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.