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 $346.74 Median $371.54 Typical High $371.54 | Professional | None | $346.74 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $281.84 Typical High $281.84 | Professional | 54 · Surgery only | $281.84 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $56.23 Typical High $56.23 | Professional | 55 · Aftercare only | $56.23 | $56.23 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $37.15 Typical High $37.15 | Professional | 56 · Pre-op care only | $37.15 | $37.15 | $37.15 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $338.84 Median $398.11 Typical High $398.11 | Professional | None | $338.84 | $398.11 | $398.11 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $275.42 Typical High $323.59 | Professional | 54 · Surgery only | $190.55 | $275.42 | $323.59 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $33.88 Typical High $39.81 | Professional | 55 · Aftercare only | $23.44 | $33.88 | $39.81 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $30.20 Typical High $35.48 | Professional | 56 · Pre-op care only | $21.38 | $30.20 | $35.48 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $3,981.07 Typical High $5,623.41 | Facility | None | $676.08 | $3,981.07 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $478.63 Typical High $478.63 | Professional | None | $416.87 | $478.63 | $478.63 |
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 $269.15 Median $295.12 Typical High $436.52 | Professional | None | $269.15 | $295.12 | $436.52 |
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 $186.21 Median $186.21 Typical High $186.21 | Professional | 52 · Reduced service | $186.21 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $74.13 Typical High $74.13 | Professional | 53 · Discontinued | $74.13 | $74.13 | $74.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $263.03 Median $263.03 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $263.03 | $263.03 | $263.03 |
Where Rhode Island sits
The same service costs 5.5 times more in Alaska than in Utah. 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· 30th of 51
$372
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.