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 $3,467.37 Median $3,715.35 Typical High $3,981.07 | Facility | None | $3,467.37 | $3,715.35 | $3,981.07 |
Aetna Setting Professional Modifier None Typical Low $1,202.26 Median $1,348.96 Typical High $1,348.96 | Professional | None | $1,202.26 | $1,348.96 | $1,348.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $1,023.29 Typical High $1,023.29 | Professional | 54 · Surgery only | $912.01 | $1,023.29 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $204.17 Typical High $204.17 | Professional | 55 · Aftercare only | $181.97 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $134.90 Typical High $134.90 | Professional | 56 · Pre-op care only | $120.23 | $134.90 | $134.90 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $1,348.96 Median $1,584.89 Typical High $2,089.30 | Professional | None | $1,348.96 | $1,584.89 | $2,089.30 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $1,096.48 Typical High $1,288.25 | Professional | 54 · Surgery only | $776.25 | $1,096.48 | $1,288.25 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $316.23 Typical High $363.08 | Professional | 55 · Aftercare only | $218.78 | $316.23 | $363.08 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $158.49 Typical High $181.97 | Professional | 56 · Pre-op care only | $109.65 | $158.49 | $181.97 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $2,884.03 Typical High $4,073.80 | Facility | None | $954.99 | $2,884.03 | $4,073.80 |
Cigna Setting Professional Modifier None Typical Low $1,230.27 Median $2,511.89 Typical High $2,511.89 | Professional | None | $1,230.27 | $2,511.89 | $2,511.89 |
United Setting Facility Modifier None Typical Low $812.83 Median $2,630.27 Typical High $8,709.64 | Facility | None | $812.83 | $2,630.27 | $8,709.64 |
United Setting Professional Modifier None Typical Low $1,071.52 Median $1,174.90 Typical High $1,905.46 | Professional | None | $1,071.52 | $1,174.90 | $1,905.46 |
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 $602.56 Median $676.08 Typical High $676.08 | Professional | 52 · Reduced service | $602.56 | $676.08 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $269.15 Typical High $269.15 | Professional | 53 · Discontinued | $239.88 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $954.99 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $851.14 | $954.99 | $954.99 |
Where Rhode Island sits
The same service costs 7.1 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· 30th of 51
$1,585
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.