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 $1,445.44 Median $1,445.44 Typical High $1,445.44 | Professional | None | $1,445.44 | $1,445.44 | $1,445.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,096.48 Median $1,096.48 Typical High $1,096.48 | Professional | 54 · Surgery only | $1,096.48 | $1,096.48 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $218.78 Typical High $218.78 | Professional | 55 · Aftercare only | $218.78 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | 56 · Pre-op care only | $144.54 | $144.54 | $144.54 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $1,318.26 Median $1,548.82 Typical High $1,548.82 | Professional | None | $1,318.26 | $1,548.82 | $1,548.82 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $1,071.52 Typical High $1,258.93 | Professional | 54 · Surgery only | $758.58 | $1,071.52 | $1,258.93 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $131.83 Typical High $154.88 | Professional | 55 · Aftercare only | $93.33 | $131.83 | $154.88 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $120.23 Typical High $141.25 | Professional | 56 · Pre-op care only | $83.18 | $120.23 | $141.25 |
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 $1,862.09 Median $1,949.84 Typical High $1,949.84 | Professional | None | $1,862.09 | $1,949.84 | $1,949.84 |
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 $1,000.00 Median $1,148.15 Typical High $1,737.80 | Professional | None | $1,000.00 | $1,148.15 | $1,737.80 |
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 $724.44 Median $724.44 Typical High $724.44 | Professional | 52 · Reduced service | $724.44 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $288.40 Median $288.40 Typical High $288.40 | Professional | 53 · Discontinued | $288.40 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,023.29 Median $1,023.29 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $1,023.29 | $1,023.29 | $1,023.29 |
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· 26th of 51
$1,445
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.