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 $3,548.13 Median $3,548.13 Typical High $3,548.13 | Professional | None | $3,548.13 | $3,548.13 | $3,548.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,691.53 Median $2,691.53 Typical High $2,691.53 | Professional | 54 · Surgery only | $2,691.53 | $2,691.53 | $2,691.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $537.03 Median $537.03 Typical High $537.03 | Professional | 55 · Aftercare only | $537.03 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $354.81 Median $354.81 Typical High $354.81 | Professional | 56 · Pre-op care only | $354.81 | $354.81 | $354.81 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $3,235.94 Median $3,801.89 Typical High $3,801.89 | Professional | None | $3,235.94 | $3,801.89 | $3,801.89 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $1,862.09 Median $2,630.27 Typical High $3,090.30 | Professional | 54 · Surgery only | $1,862.09 | $2,630.27 | $3,090.30 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $323.59 Typical High $380.19 | Professional | 55 · Aftercare only | $229.09 | $323.59 | $380.19 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $204.17 Median $295.12 Typical High $346.74 | Professional | 56 · Pre-op care only | $204.17 | $295.12 | $346.74 |
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 $4,570.88 Median $4,677.35 Typical High $4,677.35 | Professional | None | $4,570.88 | $4,677.35 | $4,677.35 |
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 $2,511.89 Median $2,818.38 Typical High $4,168.69 | Professional | None | $2,511.89 | $2,818.38 | $4,168.69 |
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 $1,778.28 Median $1,778.28 Typical High $1,778.28 | Professional | 52 · Reduced service | $1,778.28 | $1,778.28 | $1,778.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $707.95 Median $707.95 Typical High $707.95 | Professional | 53 · Discontinued | $707.95 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,511.89 Median $2,511.89 Typical High $2,511.89 | Professional | 78 · Unplanned return to OR | $2,511.89 | $2,511.89 | $2,511.89 |
Where Rhode Island sits
The same service costs 21.4 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· 26th of 51
$3,548
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.