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 $1,348.96 Median $1,348.96 Typical High $1,348.96 | Professional | None | $1,348.96 | $1,348.96 | $1,348.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,000.00 Typical High $1,000.00 | Professional | 54 · Surgery only | $1,000.00 | $1,000.00 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $199.53 Typical High $199.53 | Professional | 55 · Aftercare only | $199.53 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $134.90 Typical High $134.90 | Professional | 56 · Pre-op care only | $134.90 | $134.90 | $134.90 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $1,000.00 Median $1,318.26 Typical High $2,187.76 | Professional | None | $1,000.00 | $1,318.26 | $2,187.76 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $933.25 Typical High $1,548.82 | Professional | 54 · Surgery only | $660.69 | $933.25 | $1,548.82 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $102.33 Typical High $169.82 | Professional | 55 · Aftercare only | $70.79 | $102.33 | $169.82 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $91.20 Typical High $151.36 | Professional | 56 · Pre-op care only | $63.10 | $91.20 | $151.36 |
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 $1,348.96 Median $2,041.74 Typical High $2,290.87 | Professional | None | $1,348.96 | $2,041.74 | $2,290.87 |
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 $1,000.00 Median $1,288.25 Typical High $1,949.84 | Professional | None | $1,000.00 | $1,288.25 | $1,949.84 |
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 $660.69 Median $660.69 Typical High $660.69 | Professional | 52 · Reduced service | $660.69 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $269.15 Typical High $269.15 | Professional | 53 · Discontinued | $269.15 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $933.25 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $933.25 | $933.25 | $933.25 |
Where Rhode Island sits
The same service costs 6.6 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· 31st of 51
$1,349
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.