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 $3,715.35 Median $3,981.07 Typical High $5,495.41 | Facility | None | $3,715.35 | $3,981.07 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,122.02 | Professional | None | $1,122.02 | $1,122.02 | $1,122.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $831.76 Typical High $831.76 | Professional | 54 · Surgery only | $831.76 | $831.76 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $169.82 Typical High $169.82 | Professional | 55 · Aftercare only | $169.82 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $112.20 Typical High $112.20 | Professional | 56 · Pre-op care only | $112.20 | $112.20 | $112.20 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $812.83 Median $1,096.48 Typical High $1,862.09 | Professional | None | $812.83 | $1,096.48 | $1,862.09 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $741.31 Typical High $1,258.93 | Professional | 54 · Surgery only | $512.86 | $741.31 | $1,258.93 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $128.82 Typical High $223.87 | Professional | 55 · Aftercare only | $91.20 | $128.82 | $223.87 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $64.57 Typical High $109.65 | Professional | 56 · Pre-op care only | $45.71 | $64.57 | $109.65 |
Cigna Setting Facility Modifier None Typical Low $1,318.26 Median $3,981.07 Typical High $5,623.41 | Facility | None | $1,318.26 | $3,981.07 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $1,174.90 Median $1,548.82 Typical High $1,905.46 | Professional | None | $1,174.90 | $1,548.82 | $1,905.46 |
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 $794.33 Median $1,000.00 Typical High $1,621.81 | Professional | None | $794.33 | $1,000.00 | $1,621.81 |
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 $562.34 Median $562.34 Typical High $562.34 | Professional | 52 · Reduced service | $562.34 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $223.87 Typical High $223.87 | Professional | 53 · Discontinued | $223.87 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $776.25 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $776.25 | $776.25 | $776.25 |
Where Rhode Island sits
The same service costs 7.2 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· 37th of 51
$1,122
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.