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 $891.25 Median $954.99 Typical High $954.99 | Professional | None | $891.25 | $954.99 | $954.99 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $707.95 Typical High $707.95 | Professional | 54 · Surgery only | $707.95 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $141.25 Typical High $141.25 | Professional | 55 · Aftercare only | $141.25 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $95.50 Typical High $95.50 | Professional | 56 · Pre-op care only | $95.50 | $95.50 | $95.50 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $851.14 Median $1,000.00 Typical High $1,000.00 | Professional | None | $851.14 | $1,000.00 | $1,000.00 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $691.83 Typical High $812.83 | Professional | 54 · Surgery only | $478.63 | $691.83 | $812.83 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $85.11 Typical High $100.00 | Professional | 55 · Aftercare only | $60.26 | $85.11 | $100.00 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $77.62 Typical High $91.20 | Professional | 56 · Pre-op care only | $53.70 | $77.62 | $91.20 |
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 $977.24 Median $1,230.27 Typical High $1,230.27 | Professional | None | $977.24 | $1,230.27 | $1,230.27 |
United Setting Facility Modifier None Typical Low $933.25 Median $3,548.13 Typical High $12,589.25 | Facility | None | $933.25 | $3,548.13 | $12,589.25 |
United Setting Professional Modifier None Typical Low $660.69 Median $776.25 Typical High $1,096.48 | Professional | None | $660.69 | $776.25 | $1,096.48 |
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 $478.63 Median $478.63 Typical High $478.63 | Professional | 52 · Reduced service | $478.63 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $190.55 Typical High $190.55 | Professional | 53 · Discontinued | $190.55 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $660.69 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $660.69 | $660.69 | $660.69 |
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
$955
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.