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 $1,905.46 Median $2,187.76 Typical High $2,187.76 | Professional | None | $1,905.46 | $2,187.76 | $2,187.76 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,621.81 Median $1,621.81 Typical High $1,621.81 | Professional | 54 · Surgery only | $1,621.81 | $1,621.81 | $1,621.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $331.13 Median $331.13 Typical High $331.13 | Professional | 55 · Aftercare only | $331.13 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $218.78 Median $218.78 Typical High $218.78 | Professional | 56 · Pre-op care only | $218.78 | $218.78 | $218.78 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $1,949.84 Median $2,290.87 Typical High $2,290.87 | Professional | None | $1,949.84 | $2,290.87 | $2,290.87 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $1,096.48 Median $1,584.89 Typical High $1,862.09 | Professional | 54 · Surgery only | $1,096.48 | $1,584.89 | $1,862.09 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $194.98 Typical High $229.09 | Professional | 55 · Aftercare only | $134.90 | $194.98 | $229.09 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $173.78 Typical High $204.17 | Professional | 56 · Pre-op care only | $123.03 | $173.78 | $204.17 |
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 $2,754.23 Median $2,818.38 Typical High $2,818.38 | Professional | None | $2,754.23 | $2,818.38 | $2,818.38 |
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 $1,584.89 Median $1,778.28 Typical High $2,630.27 | Professional | None | $1,584.89 | $1,778.28 | $2,630.27 |
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 $1,096.48 Median $1,096.48 Typical High $1,096.48 | Professional | 52 · Reduced service | $1,096.48 | $1,096.48 | $1,096.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $436.52 Median $436.52 Typical High $436.52 | Professional | 53 · Discontinued | $436.52 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,513.56 Median $1,513.56 Typical High $1,513.56 | Professional | 78 · Unplanned return to OR | $1,513.56 | $1,513.56 | $1,513.56 |
Where Rhode Island sits
The same service costs 5.4 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
$2,188
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.