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 $2,818.38 Median $2,884.03 Typical High $2,884.03 | Professional | None | $2,818.38 | $2,884.03 | $2,884.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,137.96 Median $2,137.96 Typical High $2,137.96 | Professional | 54 · Surgery only | $2,137.96 | $2,137.96 | $2,137.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $426.58 Median $426.58 Typical High $426.58 | Professional | 55 · Aftercare only | $426.58 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $288.40 Median $288.40 Typical High $288.40 | Professional | 56 · Pre-op care only | $288.40 | $288.40 | $288.40 |
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 $1,445.44 Median $2,089.30 Typical High $2,454.71 | Professional | 54 · Surgery only | $1,445.44 | $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 $3,801.89 Typical High $3,801.89 | Professional | None | $3,630.78 | $3,801.89 | $3,801.89 |
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 $2,344.23 Typical High $3,388.44 | Professional | None | $2,137.96 | $2,344.23 | $3,388.44 |
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 $1,445.44 Median $1,445.44 Typical High $1,445.44 | Professional | 52 · Reduced service | $1,445.44 | $1,445.44 | $1,445.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $575.44 Median $575.44 Typical High $575.44 | Professional | 53 · Discontinued | $575.44 | $575.44 | $575.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,995.26 Median $1,995.26 Typical High $1,995.26 | Professional | 78 · Unplanned return to OR | $1,995.26 | $1,995.26 | $1,995.26 |
Where Rhode Island sits
The same service costs 22.4 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· 24th of 51
$2,884
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.