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 $2,398.83 Median $3,235.94 Typical High $3,981.07 | Facility | None | $2,398.83 | $3,235.94 | $3,981.07 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $489.78 | Professional | None | $489.78 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $371.54 Typical High $371.54 | Professional | 54 · Surgery only | $371.54 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $74.13 Typical High $74.13 | Professional | 55 · Aftercare only | $74.13 | $74.13 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $48.98 Typical High $48.98 | Professional | 56 · Pre-op care only | $48.98 | $48.98 | $48.98 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $363.08 Median $478.63 Typical High $676.08 | Professional | None | $363.08 | $478.63 | $676.08 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $281.84 Typical High $331.13 | Professional | 54 · Surgery only | $234.42 | $281.84 | $331.13 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $85.11 Typical High $100.00 | Professional | 55 · Aftercare only | $70.79 | $85.11 | $100.00 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $40.74 Typical High $47.86 | Professional | 56 · Pre-op care only | $33.88 | $40.74 | $47.86 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $4,786.30 Typical High $6,918.31 | Facility | None | $676.08 | $4,786.30 | $6,918.31 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $691.83 Typical High $812.83 | Professional | None | $537.03 | $691.83 | $812.83 |
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 $316.23 Median $398.11 Typical High $724.44 | Professional | None | $316.23 | $398.11 | $724.44 |
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 $245.47 Median $245.47 Typical High $245.47 | Professional | 52 · Reduced service | $245.47 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $97.72 Typical High $97.72 | Professional | 53 · Discontinued | $97.72 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $346.74 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $346.74 | $346.74 | $346.74 |
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· 31st of 51
$490
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.