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 $4,365.16 Median $4,365.16 Typical High $4,365.16 | Professional | None | $4,365.16 | $4,365.16 | $4,365.16 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3,311.31 Median $3,311.31 Typical High $3,311.31 | Professional | 54 · Surgery only | $3,311.31 | $3,311.31 | $3,311.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $660.69 Median $660.69 Typical High $660.69 | Professional | 55 · Aftercare only | $660.69 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $436.52 Median $436.52 Typical High $436.52 | Professional | 56 · Pre-op care only | $436.52 | $436.52 | $436.52 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $4,365.16 Median $5,128.61 Typical High $5,128.61 | Professional | None | $4,365.16 | $5,128.61 | $5,128.61 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $2,454.71 Median $3,548.13 Typical High $4,168.69 | Professional | 54 · Surgery only | $2,454.71 | $3,548.13 | $4,168.69 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $309.03 Median $436.52 Typical High $512.86 | Professional | 55 · Aftercare only | $309.03 | $436.52 | $512.86 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $275.42 Median $389.05 Typical High $467.74 | Professional | 56 · Pre-op care only | $275.42 | $389.05 | $467.74 |
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 $6,165.95 Median $6,309.57 Typical High $6,309.57 | Professional | None | $6,165.95 | $6,309.57 | $6,309.57 |
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 $3,467.37 Median $3,981.07 Typical High $5,623.41 | Professional | None | $3,467.37 | $3,981.07 | $5,623.41 |
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 $2,187.76 Median $2,187.76 Typical High $2,187.76 | Professional | 52 · Reduced service | $2,187.76 | $2,187.76 | $2,187.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $891.25 Median $891.25 Typical High $891.25 | Professional | 53 · Discontinued | $891.25 | $891.25 | $891.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $3,090.30 Median $3,090.30 Typical High $3,090.30 | Professional | 78 · Unplanned return to OR | $3,090.30 | $3,090.30 | $3,090.30 |
Where Rhode Island sits
The same service costs 21.9 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· 28th of 51
$4,365
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.