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 $3,715.35 Median $3,715.35 Typical High $3,981.07 | Facility | None | $3,715.35 | $3,715.35 | $3,981.07 |
Aetna Setting Professional Modifier None Typical Low $4,365.16 Median $4,677.35 Typical High $4,677.35 | Professional | None | $4,365.16 | $4,677.35 | $4,677.35 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3,548.13 Median $3,548.13 Typical High $3,548.13 | Professional | 54 · Surgery only | $3,548.13 | $3,548.13 | $3,548.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $707.95 Median $707.95 Typical High $707.95 | Professional | 55 · Aftercare only | $707.95 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $467.74 Median $467.74 Typical High $467.74 | Professional | 56 · Pre-op care only | $467.74 | $467.74 | $467.74 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $3,981.07 Median $4,677.35 Typical High $4,677.35 | Professional | None | $3,981.07 | $4,677.35 | $4,677.35 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $2,238.72 Median $3,235.94 Typical High $3,801.89 | Professional | 54 · Surgery only | $2,238.72 | $3,235.94 | $3,801.89 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $275.42 Median $398.11 Typical High $467.74 | Professional | 55 · Aftercare only | $275.42 | $398.11 | $467.74 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $251.19 Median $354.81 Typical High $416.87 | Professional | 56 · Pre-op care only | $251.19 | $354.81 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $676.08 Typical High $1,202.26 | Facility | None | $50.12 | $676.08 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $5,495.41 Median $5,754.40 Typical High $5,754.40 | Professional | None | $5,495.41 | $5,754.40 | $5,754.40 |
United Setting Facility Modifier None Typical Low $426.58 Median $1,513.56 Typical High $6,456.54 | Facility | None | $426.58 | $1,513.56 | $6,456.54 |
United Setting Professional Modifier None Typical Low $2,238.72 Median $3,548.13 Typical High $5,370.32 | Professional | None | $2,238.72 | $3,548.13 | $5,370.32 |
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 $2,344.23 Median $2,344.23 Typical High $2,344.23 | Professional | 52 · Reduced service | $2,344.23 | $2,344.23 | $2,344.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $954.99 Median $954.99 Typical High $954.99 | Professional | 53 · Discontinued | $954.99 | $954.99 | $954.99 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $3,311.31 Median $3,311.31 Typical High $3,311.31 | Professional | 78 · Unplanned return to OR | $3,311.31 | $3,311.31 | $3,311.31 |
Where Rhode Island sits
The same service costs 21.9 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· 22nd of 51
$4,677
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.