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 $3,981.07 Typical High $5,495.41 | Facility | None | $3,715.35 | $3,981.07 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $1,584.89 | Professional | None | $1,584.89 | $1,584.89 | $1,584.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $1,202.26 Typical High $1,202.26 | Professional | 54 · Surgery only | $1,202.26 | $1,202.26 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $239.88 Typical High $239.88 | Professional | 55 · Aftercare only | $239.88 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $158.49 Median $158.49 Typical High $158.49 | Professional | 56 · Pre-op care only | $158.49 | $158.49 | $158.49 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $1,023.29 Median $1,380.38 Typical High $2,398.83 | Professional | None | $1,023.29 | $1,380.38 | $2,398.83 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $870.96 Typical High $1,513.56 | Professional | 54 · Surgery only | $602.56 | $870.96 | $1,513.56 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $162.18 Typical High $281.84 | Professional | 55 · Aftercare only | $114.82 | $162.18 | $281.84 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $141.25 Typical High $245.47 | Professional | 56 · Pre-op care only | $97.72 | $141.25 | $245.47 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $6,606.93 Typical High $9,549.93 | Facility | None | $954.99 | $6,606.93 | $9,549.93 |
Cigna Setting Professional Modifier None Typical Low $1,288.25 Median $1,949.84 Typical High $2,398.83 | Professional | None | $1,288.25 | $1,949.84 | $2,398.83 |
United Setting Facility Modifier None Typical Low $1,023.29 Median $4,570.88 Typical High $12,882.50 | Facility | None | $1,023.29 | $4,570.88 | $12,882.50 |
United Setting Professional Modifier None Typical Low $1,023.29 Median $1,479.11 Typical High $2,041.74 | Professional | None | $1,023.29 | $1,479.11 | $2,041.74 |
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 $794.33 Median $794.33 Typical High $794.33 | Professional | 52 · Reduced service | $794.33 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $316.23 Median $316.23 Typical High $316.23 | Professional | 53 · Discontinued | $316.23 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,122.02 Median $1,122.02 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $1,122.02 | $1,122.02 | $1,122.02 |
Where Rhode Island sits
The same service costs 8.7 times more in Oklahoma 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· 29th of 51
$1,585
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.