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 $2,089.30 Median $2,754.23 Typical High $3,981.07 | Facility | None | $2,089.30 | $2,754.23 | $3,981.07 |
Aetna Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,000.00 | Professional | None | $1,000.00 | $1,000.00 | $1,000.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $758.58 Typical High $758.58 | Professional | 54 · Surgery only | $758.58 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | 55 · Aftercare only | $151.36 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | 56 · Pre-op care only | $100.00 | $100.00 | $100.00 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $1,023.29 Median $1,348.96 Typical High $1,778.28 | Professional | None | $1,023.29 | $1,348.96 | $1,778.28 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $870.96 Typical High $1,023.29 | Professional | 54 · Surgery only | $724.44 | $870.96 | $1,023.29 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $151.36 Typical High $177.83 | Professional | 55 · Aftercare only | $123.03 | $151.36 | $177.83 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $125.89 Typical High $147.91 | Professional | 56 · Pre-op care only | $104.71 | $125.89 | $147.91 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $1,513.56 Typical High $1,778.28 | Facility | None | $588.84 | $1,513.56 | $1,778.28 |
Cigna Setting Professional Modifier None Typical Low $1,348.96 Median $1,862.09 Typical High $1,862.09 | Professional | None | $1,348.96 | $1,862.09 | $1,862.09 |
United Setting Facility Modifier None Typical Low $870.96 Median $2,089.30 Typical High $5,888.44 | Facility | None | $870.96 | $2,089.30 | $5,888.44 |
United Setting Professional Modifier None Typical Low $831.76 Median $1,000.00 Typical High $2,041.74 | Professional | None | $831.76 | $1,000.00 | $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 $501.19 Median $501.19 Typical High $501.19 | Professional | 52 · Reduced service | $501.19 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $204.17 Typical High $204.17 | Professional | 53 · Discontinued | $204.17 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $707.95 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $707.95 | $707.95 | $707.95 |
Where Rhode Island sits
The same service costs 5.9 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· 24th of 51
$1,349
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.