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 $5,495.41 Median $5,495.41 Typical High $5,495.41 | Professional | None | $5,495.41 | $5,495.41 | $5,495.41 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $4,073.80 Median $4,073.80 Typical High $4,073.80 | Professional | 54 · Surgery only | $4,073.80 | $4,073.80 | $4,073.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $812.83 Median $812.83 Typical High $812.83 | Professional | 55 · Aftercare only | $812.83 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $549.54 Median $549.54 Typical High $549.54 | Professional | 56 · Pre-op care only | $549.54 | $549.54 | $549.54 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $3,467.37 Median $4,677.35 Typical High $6,760.83 | Professional | None | $3,467.37 | $4,677.35 | $6,760.83 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $2,238.72 Median $2,754.23 Typical High $3,235.94 | Professional | 54 · Surgery only | $2,238.72 | $2,754.23 | $3,235.94 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $676.08 Median $831.76 Typical High $977.24 | Professional | 55 · Aftercare only | $676.08 | $831.76 | $977.24 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $323.59 Median $398.11 Typical High $467.74 | Professional | 56 · Pre-op care only | $323.59 | $398.11 | $467.74 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $18,197.01 Typical High $26,302.68 | Facility | None | $676.08 | $18,197.01 | $26,302.68 |
Cigna Setting Professional Modifier None Typical Low $6,165.95 Median $6,918.31 Typical High $8,128.31 | Professional | None | $6,165.95 | $6,918.31 | $8,128.31 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $5,623.41 Typical High $19,054.61 | Facility | None | $1,230.27 | $5,623.41 | $19,054.61 |
United Setting Professional Modifier None Typical Low $3,235.94 Median $4,570.88 Typical High $7,413.10 | Professional | None | $3,235.94 | $4,570.88 | $7,413.10 |
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 $2,754.23 Median $2,754.23 Typical High $2,754.23 | Professional | 52 · Reduced service | $2,754.23 | $2,754.23 | $2,754.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1,096.48 Median $1,096.48 Typical High $1,096.48 | Professional | 53 · Discontinued | $1,096.48 | $1,096.48 | $1,096.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $3,801.89 Median $3,801.89 Typical High $3,801.89 | Professional | 78 · Unplanned return to OR | $3,801.89 | $3,801.89 | $3,801.89 |
Where Rhode Island sits
The same service costs 20.4 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· 20th of 51
$5,495
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.