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 $724.44 Median $724.44 Typical High $724.44 | Professional | None | $724.44 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $549.54 Typical High $549.54 | Professional | 54 · Surgery only | $549.54 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | 55 · Aftercare only | $109.65 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $72.44 Typical High $72.44 | Professional | 56 · Pre-op care only | $72.44 | $72.44 | $72.44 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $446.68 Median $602.56 Typical High $1,023.29 | Professional | None | $446.68 | $602.56 | $1,023.29 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $346.74 Typical High $416.87 | Professional | 54 · Surgery only | $288.40 | $346.74 | $416.87 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $107.15 Typical High $125.89 | Professional | 55 · Aftercare only | $87.10 | $107.15 | $125.89 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $51.29 Typical High $60.26 | Professional | 56 · Pre-op care only | $41.69 | $51.29 | $60.26 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $3,981.07 Typical High $5,623.41 | Facility | None | $954.99 | $3,981.07 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $851.14 Typical High $1,023.29 | Professional | None | $758.58 | $851.14 | $1,023.29 |
United Setting Facility Modifier None Typical Low $870.96 Median $2,089.30 Typical High $7,413.10 | Facility | None | $870.96 | $2,089.30 | $7,413.10 |
United Setting Professional Modifier None Typical Low $416.87 Median $602.56 Typical High $954.99 | Professional | None | $416.87 | $602.56 | $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 $363.08 Median $363.08 Typical High $363.08 | Professional | 52 · Reduced service | $363.08 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $147.91 Typical High $147.91 | Professional | 53 · Discontinued | $147.91 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $512.86 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $512.86 | $512.86 | $512.86 |
Where Rhode Island sits
The same service costs 18.2 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· 24th of 51
$724
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.