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 $2,884.03 Median $3,019.95 Typical High $3,019.95 | Professional | None | $2,884.03 | $3,019.95 | $3,019.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,290.87 Median $2,290.87 Typical High $2,290.87 | Professional | 54 · Surgery only | $2,290.87 | $2,290.87 | $2,290.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $457.09 Median $457.09 Typical High $457.09 | Professional | 55 · Aftercare only | $457.09 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $302.00 Median $302.00 Typical High $302.00 | Professional | 56 · Pre-op care only | $302.00 | $302.00 | $302.00 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $2,754.23 Median $3,235.94 Typical High $3,235.94 | Professional | None | $2,754.23 | $3,235.94 | $3,235.94 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $1,584.89 Median $2,238.72 Typical High $2,630.27 | Professional | 54 · Surgery only | $1,584.89 | $2,238.72 | $2,630.27 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $275.42 Typical High $323.59 | Professional | 55 · Aftercare only | $194.98 | $275.42 | $323.59 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $173.78 Median $251.19 Typical High $295.12 | Professional | 56 · Pre-op care only | $173.78 | $251.19 | $295.12 |
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 $3,890.45 Median $3,981.07 Typical High $3,981.07 | Professional | None | $3,890.45 | $3,981.07 | $3,981.07 |
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 $2,137.96 Median $2,398.83 Typical High $3,630.78 | Professional | None | $2,137.96 | $2,398.83 | $3,630.78 |
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 $1,513.56 Median $1,513.56 Typical High $1,513.56 | Professional | 52 · Reduced service | $1,513.56 | $1,513.56 | $1,513.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $602.56 Median $602.56 Typical High $602.56 | Professional | 53 · Discontinued | $602.56 | $602.56 | $602.56 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,137.96 Median $2,137.96 Typical High $2,137.96 | Professional | 78 · Unplanned return to OR | $2,137.96 | $2,137.96 | $2,137.96 |
Where Rhode Island sits
The same service costs 21.4 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· 25th of 51
$3,020
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.