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 $3,019.95 Median $3,715.35 Typical High $3,981.07 | Facility | None | $3,019.95 | $3,715.35 | $3,981.07 |
Aetna Setting Professional Modifier None Typical Low $6,025.60 Median $6,165.95 Typical High $6,165.95 | Professional | None | $6,025.60 | $6,165.95 | $6,165.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $4,677.35 Median $4,677.35 Typical High $4,677.35 | Professional | 54 · Surgery only | $4,677.35 | $4,677.35 | $4,677.35 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $933.25 Median $933.25 Typical High $933.25 | Professional | 55 · Aftercare only | $933.25 | $933.25 | $933.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $616.60 Median $616.60 Typical High $616.60 | Professional | 56 · Pre-op care only | $616.60 | $616.60 | $616.60 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $5,495.41 Median $6,456.54 Typical High $6,456.54 | Professional | None | $5,495.41 | $6,456.54 | $6,456.54 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $3,090.30 Median $4,466.84 Typical High $5,248.07 | Professional | 54 · Surgery only | $3,090.30 | $4,466.84 | $5,248.07 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $380.19 Median $549.54 Typical High $645.65 | Professional | 55 · Aftercare only | $380.19 | $549.54 | $645.65 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $346.74 Median $489.78 Typical High $575.44 | Professional | 56 · Pre-op care only | $346.74 | $489.78 | $575.44 |
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 $7,585.78 Median $7,943.28 Typical High $7,943.28 | Professional | None | $7,585.78 | $7,943.28 | $7,943.28 |
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 $4,570.88 Median $5,011.87 Typical High $7,413.10 | Professional | None | $4,570.88 | $5,011.87 | $7,413.10 |
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 $3,090.30 Median $3,090.30 Typical High $3,090.30 | Professional | 52 · Reduced service | $3,090.30 | $3,090.30 | $3,090.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Professional | 53 · Discontinued | $1,230.27 | $1,230.27 | $1,230.27 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $4,365.16 Median $4,365.16 Typical High $4,365.16 | Professional | 78 · Unplanned return to OR | $4,365.16 | $4,365.16 | $4,365.16 |
Where Rhode Island sits
The same service costs 20.0 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
$6,166
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.