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 $1,995.26 Median $1,995.26 Typical High $1,995.26 | Professional | None | $1,995.26 | $1,995.26 | $1,995.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,513.56 Median $1,513.56 Typical High $1,513.56 | Professional | 54 · Surgery only | $1,513.56 | $1,513.56 | $1,513.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $302.00 Median $302.00 Typical High $302.00 | Professional | 55 · Aftercare only | $302.00 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $199.53 Median $199.53 Typical High $199.53 | Professional | 56 · Pre-op care only | $199.53 | $199.53 | $199.53 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $1,348.96 Median $1,778.28 Typical High $3,019.95 | Professional | None | $1,348.96 | $1,778.28 | $3,019.95 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $1,258.93 Typical High $2,089.30 | Professional | 54 · Surgery only | $891.25 | $1,258.93 | $2,089.30 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $138.04 Typical High $229.09 | Professional | 55 · Aftercare only | $95.50 | $138.04 | $229.09 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $120.23 Typical High $204.17 | Professional | 56 · Pre-op care only | $85.11 | $120.23 | $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 $1,949.84 Median $2,691.53 Typical High $3,090.30 | Professional | None | $1,949.84 | $2,691.53 | $3,090.30 |
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 $1,318.26 Median $1,819.70 Typical High $2,630.27 | Professional | None | $1,318.26 | $1,819.70 | $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 $1,000.00 Median $1,000.00 Typical High $1,000.00 | Professional | 52 · Reduced service | $1,000.00 | $1,000.00 | $1,000.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $398.11 Median $398.11 Typical High $398.11 | Professional | 53 · Discontinued | $398.11 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,412.54 Median $1,412.54 Typical High $1,412.54 | Professional | 78 · Unplanned return to OR | $1,412.54 | $1,412.54 | $1,412.54 |
Where Rhode Island sits
The same service costs 5.9 times more in Alaska than in Utah. 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· 22nd of 51
$1,995
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.