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 $1,862.09 Median $1,862.09 Typical High $1,862.09 | Professional | None | $1,862.09 | $1,862.09 | $1,862.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,380.38 Median $1,380.38 Typical High $1,380.38 | Professional | 54 · Surgery only | $1,380.38 | $1,380.38 | $1,380.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $275.42 Median $275.42 Typical High $275.42 | Professional | 55 · Aftercare only | $275.42 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $186.21 Median $186.21 Typical High $186.21 | Professional | 56 · Pre-op care only | $186.21 | $186.21 | $186.21 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $1,318.26 Median $1,778.28 Typical High $3,019.95 | Professional | None | $1,318.26 | $1,778.28 | $3,019.95 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $1,148.15 Typical High $1,348.96 | Professional | 54 · Surgery only | $933.25 | $1,148.15 | $1,348.96 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $194.98 Typical High $229.09 | Professional | 55 · Aftercare only | $162.18 | $194.98 | $229.09 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $165.96 Typical High $194.98 | Professional | 56 · Pre-op care only | $134.90 | $165.96 | $194.98 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $5,370.32 Typical High $7,762.47 | Facility | None | $676.08 | $5,370.32 | $7,762.47 |
Cigna Setting Professional Modifier None Typical Low $2,041.74 Median $2,454.71 Typical High $2,951.21 | Professional | None | $2,041.74 | $2,454.71 | $2,951.21 |
United Setting Facility Modifier None Typical Low $933.25 Median $3,548.13 Typical High $12,589.25 | Facility | None | $933.25 | $3,548.13 | $12,589.25 |
United Setting Professional Modifier None Typical Low $1,174.90 Median $1,513.56 Typical High $2,691.53 | Professional | None | $1,174.90 | $1,513.56 | $2,691.53 |
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 $933.25 Median $933.25 Typical High $933.25 | Professional | 52 · Reduced service | $933.25 | $933.25 | $933.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $371.54 Median $371.54 Typical High $371.54 | Professional | 53 · Discontinued | $371.54 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,288.25 Median $1,288.25 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $1,288.25 | $1,288.25 | $1,288.25 |
Where Rhode Island sits
The same service costs 24.5 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· 28th of 51
$1,862
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.