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 $2,511.89 Median $2,511.89 Typical High $2,511.89 | Professional | None | $2,511.89 | $2,511.89 | $2,511.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,905.46 Median $1,905.46 Typical High $1,905.46 | Professional | 54 · Surgery only | $1,905.46 | $1,905.46 | $1,905.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $380.19 Median $380.19 Typical High $380.19 | Professional | 55 · Aftercare only | $380.19 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $251.19 Median $251.19 Typical High $251.19 | Professional | 56 · Pre-op care only | $251.19 | $251.19 | $251.19 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $2,570.40 Median $3,019.95 Typical High $3,019.95 | Professional | None | $2,570.40 | $3,019.95 | $3,019.95 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $1,479.11 Median $2,089.30 Typical High $2,454.71 | Professional | 54 · Surgery only | $1,479.11 | $2,089.30 | $2,454.71 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $257.04 Typical High $302.00 | Professional | 55 · Aftercare only | $181.97 | $257.04 | $302.00 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $162.18 Median $234.42 Typical High $275.42 | Professional | 56 · Pre-op care only | $162.18 | $234.42 | $275.42 |
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 $3,630.78 Median $3,715.35 Typical High $3,715.35 | Professional | None | $3,630.78 | $3,715.35 | $3,715.35 |
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 $1,949.84 Median $2,187.76 Typical High $3,311.31 | Professional | None | $1,949.84 | $2,187.76 | $3,311.31 |
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 $1,258.93 Median $1,258.93 Typical High $1,258.93 | Professional | 52 · Reduced service | $1,258.93 | $1,258.93 | $1,258.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $512.86 Median $512.86 Typical High $512.86 | Professional | 53 · Discontinued | $512.86 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,778.28 Median $1,778.28 Typical High $1,778.28 | Professional | 78 · Unplanned return to OR | $1,778.28 | $1,778.28 | $1,778.28 |
Where Rhode Island sits
The same service costs 20.9 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· 30th of 51
$2,570
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.