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 $3,467.37 Median $3,715.35 Typical High $3,981.07 | Facility | None | $3,467.37 | $3,715.35 | $3,981.07 |
Aetna Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,122.02 | Professional | None | $1,122.02 | $1,122.02 | $1,122.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $851.14 Typical High $851.14 | Professional | 54 · Surgery only | $851.14 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $169.82 Typical High $169.82 | Professional | 55 · Aftercare only | $169.82 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $112.20 Typical High $112.20 | Professional | 56 · Pre-op care only | $112.20 | $112.20 | $112.20 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $758.58 Median $1,000.00 Typical High $1,659.59 | Professional | None | $758.58 | $1,000.00 | $1,659.59 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $630.96 Typical High $1,047.13 | Professional | 54 · Surgery only | $436.52 | $630.96 | $1,047.13 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $120.23 Typical High $199.53 | Professional | 55 · Aftercare only | $83.18 | $120.23 | $199.53 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $102.33 Typical High $169.82 | Professional | 56 · Pre-op care only | $70.79 | $102.33 | $169.82 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $6,606.93 Typical High $9,549.93 | Facility | None | $676.08 | $6,606.93 | $9,549.93 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $1,445.44 Typical High $1,737.80 | Professional | None | $933.25 | $1,445.44 | $1,737.80 |
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 $741.31 Median $1,096.48 Typical High $1,479.11 | Professional | None | $741.31 | $1,096.48 | $1,479.11 |
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 $562.34 Median $562.34 Typical High $562.34 | Professional | 52 · Reduced service | $562.34 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | 53 · Discontinued | $229.09 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $794.33 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $794.33 | $794.33 | $794.33 |
Where Rhode Island sits
The same service costs 11.0 times more in Oklahoma 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· 27th of 51
$1,148
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.