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 $3,019.95 Median $3,715.35 Typical High $3,981.07 | Facility | None | $3,019.95 | $3,715.35 | $3,981.07 |
Aetna Setting Professional Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $1,621.81 | Professional | None | $1,621.81 | $1,621.81 | $1,621.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Professional | 54 · Surgery only | $1,230.27 | $1,230.27 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $245.47 Median $245.47 Typical High $245.47 | Professional | 55 · Aftercare only | $245.47 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | 56 · Pre-op care only | $162.18 | $162.18 | $162.18 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $1,148.15 Median $1,513.56 Typical High $2,137.96 | Professional | None | $1,148.15 | $1,513.56 | $2,137.96 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $891.25 Typical High $1,047.13 | Professional | 54 · Surgery only | $724.44 | $891.25 | $1,047.13 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $269.15 Typical High $316.23 | Professional | 55 · Aftercare only | $223.87 | $269.15 | $316.23 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $128.82 Typical High $151.36 | Professional | 56 · Pre-op care only | $107.15 | $128.82 | $151.36 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $12,589.25 Typical High $18,197.01 | Facility | None | $831.76 | $12,589.25 | $18,197.01 |
Cigna Setting Professional Modifier None Typical Low $1,698.24 Median $2,238.72 Typical High $2,570.40 | Professional | None | $1,698.24 | $2,238.72 | $2,570.40 |
United Setting Facility Modifier None Typical Low $1,023.29 Median $4,570.88 Typical High $12,882.50 | Facility | None | $1,023.29 | $4,570.88 | $12,882.50 |
United Setting Professional Modifier None Typical Low $1,023.29 Median $1,348.96 Typical High $2,344.23 | Professional | None | $1,023.29 | $1,348.96 | $2,344.23 |
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 $812.83 Median $812.83 Typical High $812.83 | Professional | 52 · Reduced service | $812.83 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $323.59 Median $323.59 Typical High $323.59 | Professional | 53 · Discontinued | $323.59 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,148.15 Median $1,148.15 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $1,148.15 | $1,148.15 | $1,148.15 |
Where Rhode Island sits
The same service costs 7.6 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· 27th of 51
$1,622
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.