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 $2,398.83 Median $3,235.94 Typical High $3,981.07 | Facility | None | $2,398.83 | $3,235.94 | $3,981.07 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $851.14 | Professional | None | $812.83 | $812.83 | $851.14 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $616.60 Typical High $630.96 | Professional | 54 · Surgery only | $616.60 | $616.60 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $123.03 Typical High $125.89 | Professional | 55 · Aftercare only | $123.03 | $123.03 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $81.28 Typical High $85.11 | Professional | 56 · Pre-op care only | $81.28 | $81.28 | $85.11 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $891.25 Median $1,174.90 Typical High $1,548.82 | Professional | None | $891.25 | $1,174.90 | $1,548.82 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $758.58 Typical High $912.01 | Professional | 54 · Surgery only | $630.96 | $758.58 | $912.01 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $131.83 Typical High $154.88 | Professional | 55 · Aftercare only | $107.15 | $131.83 | $154.88 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $112.20 Typical High $131.83 | Professional | 56 · Pre-op care only | $91.20 | $112.20 | $131.83 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $776.25 Typical High $1,412.54 | Facility | None | $588.84 | $776.25 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $1,174.90 Median $1,621.81 Typical High $1,949.84 | Professional | None | $1,174.90 | $1,621.81 | $1,949.84 |
United Setting Facility Modifier None Typical Low $371.54 Median $1,096.48 Typical High $4,265.80 | Facility | None | $371.54 | $1,096.48 | $4,265.80 |
United Setting Professional Modifier None Typical Low $724.44 Median $891.25 Typical High $1,778.28 | Professional | None | $724.44 | $891.25 | $1,778.28 |
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 $407.38 Median $407.38 Typical High $426.58 | Professional | 52 · Reduced service | $407.38 | $407.38 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $162.18 Typical High $169.82 | Professional | 53 · Discontinued | $162.18 | $162.18 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $575.44 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $575.44 | $575.44 | $588.84 |
Where Rhode Island sits
The same service costs 22.4 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· 20th of 51
$1,175
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.