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 $3,715.35 Typical High $3,981.07 | Facility | None | $3,715.35 | $3,715.35 | $3,981.07 |
Aetna Setting Professional Modifier None Typical Low $446.68 Median $478.63 Typical High $588.84 | Professional | None | $446.68 | $478.63 | $588.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $354.81 Typical High $446.68 | Professional | 54 · Surgery only | $338.84 | $354.81 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $70.79 Typical High $89.13 | Professional | 55 · Aftercare only | $67.61 | $70.79 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $47.86 Typical High $58.88 | Professional | 56 · Pre-op care only | $44.67 | $47.86 | $58.88 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $371.54 Median $478.63 Typical High $758.58 | Professional | None | $371.54 | $478.63 | $758.58 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $302.00 Typical High $501.19 | Professional | 54 · Surgery only | $218.78 | $302.00 | $501.19 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $79.43 Typical High $131.83 | Professional | 55 · Aftercare only | $57.54 | $79.43 | $131.83 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $41.69 Typical High $69.18 | Professional | 56 · Pre-op care only | $30.20 | $41.69 | $69.18 |
Cigna Setting Facility Modifier None Typical Low $269.15 Median $489.78 Typical High $1,202.26 | Facility | None | $269.15 | $489.78 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $380.19 Median $501.19 Typical High $1,148.15 | Professional | None | $380.19 | $501.19 | $1,148.15 |
United Setting Facility Modifier None Typical Low $97.72 Median $316.23 Typical High $3,890.45 | Facility | None | $97.72 | $316.23 | $3,890.45 |
United Setting Professional Modifier None Typical Low $354.81 Median $549.54 Typical High $954.99 | Professional | None | $354.81 | $549.54 | $954.99 |
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 $223.87 Median $239.88 Typical High $295.12 | Professional | 52 · Reduced service | $223.87 | $239.88 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $95.50 Typical High $117.49 | Professional | 53 · Discontinued | $89.13 | $95.50 | $117.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $331.13 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $316.23 | $331.13 | $416.87 |
Where Rhode Island sits
The same service costs 5.1 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
$501
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.