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 $1,445.44 Median $1,445.44 Typical High $1,445.44 | Professional | None | $1,445.44 | $1,445.44 | $1,445.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,071.52 Typical High $1,071.52 | Professional | 54 · Surgery only | $1,071.52 | $1,071.52 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $213.80 Typical High $213.80 | Professional | 55 · Aftercare only | $213.80 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | 56 · Pre-op care only | $144.54 | $144.54 | $144.54 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $1,318.26 Median $1,548.82 Typical High $1,548.82 | Professional | None | $1,318.26 | $1,548.82 | $1,548.82 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $1,071.52 Typical High $1,258.93 | Professional | 54 · Surgery only | $741.31 | $1,071.52 | $1,258.93 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $131.83 Typical High $154.88 | Professional | 55 · Aftercare only | $91.20 | $131.83 | $154.88 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $117.49 Typical High $138.04 | Professional | 56 · Pre-op care only | $83.18 | $117.49 | $138.04 |
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 $1,862.09 Median $1,905.46 Typical High $1,905.46 | Professional | None | $1,862.09 | $1,905.46 | $1,905.46 |
United Setting Facility Modifier None Typical Low $645.65 Median $1,348.96 Typical High $5,011.87 | Facility | None | $645.65 | $1,348.96 | $5,011.87 |
United Setting Professional Modifier None Typical Low $977.24 Median $1,122.02 Typical High $1,698.24 | Professional | None | $977.24 | $1,122.02 | $1,698.24 |
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 $707.95 Median $707.95 Typical High $707.95 | Professional | 52 · Reduced service | $707.95 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $288.40 Median $288.40 Typical High $288.40 | Professional | 53 · Discontinued | $288.40 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,000.00 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,000.00 | $1,000.00 |
Where Rhode Island sits
The same service costs 5.5 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· 24th of 51
$1,445
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.