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 $1,174.90 Median $1,202.26 Typical High $1,202.26 | Professional | None | $1,174.90 | $1,202.26 | $1,202.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $912.01 Typical High $912.01 | Professional | 54 · Surgery only | $912.01 | $912.01 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $181.97 Typical High $181.97 | Professional | 55 · Aftercare only | $181.97 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | 56 · Pre-op care only | $120.23 | $120.23 | $120.23 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $1,096.48 Median $1,288.25 Typical High $1,288.25 | Professional | None | $1,096.48 | $1,288.25 | $1,288.25 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $891.25 Typical High $1,047.13 | Professional | 54 · Surgery only | $616.60 | $891.25 | $1,047.13 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $109.65 Typical High $128.82 | Professional | 55 · Aftercare only | $77.62 | $109.65 | $128.82 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $100.00 Typical High $117.49 | Professional | 56 · Pre-op care only | $69.18 | $100.00 | $117.49 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $1,949.84 Typical High $2,754.23 | Facility | None | $954.99 | $1,949.84 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $1,258.93 Median $1,584.89 Typical High $1,584.89 | Professional | None | $1,258.93 | $1,584.89 | $1,584.89 |
United Setting Facility Modifier None Typical Low $933.25 Median $3,548.13 Typical High $10,232.93 | Facility | None | $933.25 | $3,548.13 | $10,232.93 |
United Setting Professional Modifier None Typical Low $891.25 Median $1,000.00 Typical High $1,445.44 | Professional | None | $891.25 | $1,000.00 | $1,445.44 |
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 $602.56 Median $602.56 Typical High $602.56 | Professional | 52 · Reduced service | $602.56 | $602.56 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $245.47 Typical High $245.47 | Professional | 53 · Discontinued | $245.47 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $851.14 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $851.14 | $851.14 | $851.14 |
Where Rhode Island sits
The same service costs 6.2 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· 25th of 51
$1,202
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.