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 $1,513.56 Median $1,548.82 Typical High $3,981.07 | Facility | None | $1,513.56 | $1,548.82 | $3,981.07 |
Aetna Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,380.38 | Professional | None | $1,380.38 | $1,380.38 | $1,380.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,023.29 Typical High $1,023.29 | Professional | 54 · Surgery only | $1,023.29 | $1,023.29 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $204.17 Typical High $204.17 | Professional | 55 · Aftercare only | $204.17 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | 56 · Pre-op care only | $138.04 | $138.04 | $138.04 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $1,202.26 Median $1,621.81 Typical High $2,344.23 | Professional | None | $1,202.26 | $1,621.81 | $2,344.23 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $1,047.13 Typical High $1,230.27 | Professional | 54 · Surgery only | $851.14 | $1,047.13 | $1,230.27 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $177.83 Typical High $208.93 | Professional | 55 · Aftercare only | $147.91 | $177.83 | $208.93 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $151.36 Typical High $177.83 | Professional | 56 · Pre-op care only | $123.03 | $151.36 | $177.83 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $5,370.32 Typical High $7,762.47 | Facility | None | $446.68 | $5,370.32 | $7,762.47 |
Cigna Setting Professional Modifier None Typical Low $2,041.74 Median $2,238.72 Typical High $2,691.53 | Professional | None | $2,041.74 | $2,238.72 | $2,691.53 |
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 $1,071.52 Median $1,412.54 Typical High $2,454.71 | Professional | None | $1,071.52 | $1,412.54 | $2,454.71 |
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 $691.83 Median $691.83 Typical High $691.83 | Professional | 52 · Reduced service | $691.83 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $275.42 Typical High $275.42 | Professional | 53 · Discontinued | $275.42 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $954.99 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $954.99 | $954.99 | $954.99 |
Where Rhode Island sits
The same service costs 7.9 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· 31st of 51
$1,622
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.