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 $5,495.41 Median $5,888.44 Typical High $5,888.44 | Professional | None | $5,495.41 | $5,888.44 | $5,888.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $4,365.16 Median $4,365.16 Typical High $4,365.16 | Professional | 54 · Surgery only | $4,365.16 | $4,365.16 | $4,365.16 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $870.96 Median $870.96 Typical High $870.96 | Professional | 55 · Aftercare only | $870.96 | $870.96 | $870.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $588.84 Median $588.84 Typical High $588.84 | Professional | 56 · Pre-op care only | $588.84 | $588.84 | $588.84 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $4,897.79 Median $5,754.40 Typical High $5,754.40 | Professional | None | $4,897.79 | $5,754.40 | $5,754.40 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $2,818.38 Median $3,981.07 Typical High $4,677.35 | Professional | 54 · Surgery only | $2,818.38 | $3,981.07 | $4,677.35 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $346.74 Median $489.78 Typical High $575.44 | Professional | 55 · Aftercare only | $346.74 | $489.78 | $575.44 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $309.03 Median $446.68 Typical High $524.81 | Professional | 56 · Pre-op care only | $309.03 | $446.68 | $524.81 |
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 $6,918.31 Median $7,244.36 Typical High $7,244.36 | Professional | None | $6,918.31 | $7,244.36 | $7,244.36 |
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 $4,365.16 Typical High $6,606.93 | Professional | None | $2,238.72 | $4,365.16 | $6,606.93 |
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 $2,951.21 Median $2,951.21 Typical High $2,951.21 | Professional | 52 · Reduced service | $2,951.21 | $2,951.21 | $2,951.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1,174.90 Median $1,174.90 Typical High $1,174.90 | Professional | 53 · Discontinued | $1,174.90 | $1,174.90 | $1,174.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $4,073.80 Median $4,073.80 Typical High $4,073.80 | Professional | 78 · Unplanned return to OR | $4,073.80 | $4,073.80 | $4,073.80 |
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
$5,888
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.