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 $3,162.28 Median $3,162.28 Typical High $3,162.28 | Professional | None | $3,162.28 | $3,162.28 | $3,162.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,398.83 Median $2,398.83 Typical High $2,398.83 | Professional | 54 · Surgery only | $2,398.83 | $2,398.83 | $2,398.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $478.63 Median $478.63 Typical High $478.63 | Professional | 55 · Aftercare only | $478.63 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $316.23 Median $316.23 Typical High $316.23 | Professional | 56 · Pre-op care only | $316.23 | $316.23 | $316.23 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $2,454.71 Median $3,235.94 Typical High $5,888.44 | Professional | None | $2,454.71 | $3,235.94 | $5,888.44 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $1,479.11 Median $2,089.30 Typical High $3,801.89 | Professional | 54 · Surgery only | $1,479.11 | $2,089.30 | $3,801.89 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $251.19 Median $363.08 Typical High $660.69 | Professional | 55 · Aftercare only | $251.19 | $363.08 | $660.69 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $213.80 Median $302.00 Typical High $549.54 | Professional | 56 · Pre-op care only | $213.80 | $302.00 | $549.54 |
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 $2,884.03 Median $4,570.88 Typical High $5,623.41 | Professional | None | $2,884.03 | $4,570.88 | $5,623.41 |
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 $1,949.84 Median $2,884.03 Typical High $4,786.30 | Professional | None | $1,949.84 | $2,884.03 | $4,786.30 |
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 $1,584.89 Median $1,584.89 Typical High $1,584.89 | Professional | 52 · Reduced service | $1,584.89 | $1,584.89 | $1,584.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $645.65 Median $645.65 Typical High $645.65 | Professional | 53 · Discontinued | $645.65 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,238.72 Median $2,238.72 Typical High $2,238.72 | Professional | 78 · Unplanned return to OR | $2,238.72 | $2,238.72 | $2,238.72 |
Where Rhode Island sits
The same service costs 17.0 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· 29th of 51
$3,162
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.