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 $3,019.95 Median $3,019.95 Typical High $3,019.95 | Professional | None | $3,019.95 | $3,019.95 | $3,019.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,238.72 Median $2,238.72 Typical High $2,238.72 | Professional | 54 · Surgery only | $2,238.72 | $2,238.72 | $2,238.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $446.68 Median $446.68 Typical High $446.68 | Professional | 55 · Aftercare only | $446.68 | $446.68 | $446.68 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $302.00 Median $302.00 Typical High $302.00 | Professional | 56 · Pre-op care only | $302.00 | $302.00 | $302.00 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $2,290.87 Median $3,090.30 Typical High $5,370.32 | Professional | None | $2,290.87 | $3,090.30 | $5,370.32 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $1,380.38 Median $1,995.26 Typical High $3,467.37 | Professional | 54 · Surgery only | $1,380.38 | $1,995.26 | $3,467.37 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $338.84 Typical High $588.84 | Professional | 55 · Aftercare only | $239.88 | $338.84 | $588.84 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $199.53 Median $288.40 Typical High $501.19 | Professional | 56 · Pre-op care only | $199.53 | $288.40 | $501.19 |
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 $3,467.37 Median $4,265.80 Typical High $5,370.32 | Professional | None | $3,467.37 | $4,265.80 | $5,370.32 |
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 $2,290.87 Median $2,691.53 Typical High $4,466.84 | Professional | None | $2,290.87 | $2,691.53 | $4,466.84 |
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 $1,479.11 Median $1,479.11 Typical High $1,479.11 | Professional | 52 · Reduced service | $1,479.11 | $1,479.11 | $1,479.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $602.56 Median $602.56 Typical High $602.56 | Professional | 53 · Discontinued | $602.56 | $602.56 | $602.56 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,089.30 Median $2,089.30 Typical High $2,089.30 | Professional | 78 · Unplanned return to OR | $2,089.30 | $2,089.30 | $2,089.30 |
Where Rhode Island sits
The same service costs 10.0 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· 31st of 51
$3,020
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.