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 $1,445.44 Median $1,445.44 Typical High $1,445.44 | Professional | None | $1,445.44 | $1,445.44 | $1,445.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,096.48 Median $1,096.48 Typical High $1,096.48 | Professional | 54 · Surgery only | $1,096.48 | $1,096.48 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $218.78 Typical High $218.78 | Professional | 55 · Aftercare only | $218.78 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | 56 · Pre-op care only | $144.54 | $144.54 | $144.54 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $1,096.48 Median $1,445.44 Typical High $2,041.74 | Professional | None | $1,096.48 | $1,445.44 | $2,041.74 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $933.25 Typical High $1,096.48 | Professional | 54 · Surgery only | $776.25 | $933.25 | $1,096.48 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $162.18 Typical High $190.55 | Professional | 55 · Aftercare only | $131.83 | $162.18 | $190.55 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $134.90 Typical High $158.49 | Professional | 56 · Pre-op care only | $112.20 | $134.90 | $158.49 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $1,230.27 Typical High $1,778.28 | Facility | None | $588.84 | $1,230.27 | $1,778.28 |
Cigna Setting Professional Modifier None Typical Low $1,778.28 Median $1,995.26 Typical High $2,398.83 | Professional | None | $1,778.28 | $1,995.26 | $2,398.83 |
United Setting Facility Modifier None Typical Low $812.83 Median $2,630.27 Typical High $7,762.47 | Facility | None | $812.83 | $2,630.27 | $7,762.47 |
United Setting Professional Modifier None Typical Low $977.24 Median $1,318.26 Typical High $2,187.76 | Professional | None | $977.24 | $1,318.26 | $2,187.76 |
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 $724.44 Median $724.44 Typical High $724.44 | Professional | 52 · Reduced service | $724.44 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $295.12 Typical High $295.12 | Professional | 53 · Discontinued | $295.12 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,023.29 Median $1,023.29 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $1,023.29 | $1,023.29 | $1,023.29 |
Where Rhode Island sits
The same service costs 6.2 times more in Alaska 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· 31st of 51
$1,445
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.