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 $2,089.30 Median $2,754.23 Typical High $3,981.07 | Facility | None | $2,089.30 | $2,754.23 | $3,981.07 |
Aetna Setting Professional Modifier None Typical Low $851.14 Median $1,122.02 Typical High $3,090.30 | Professional | None | $851.14 | $1,122.02 | $3,090.30 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $831.76 Typical High $2,290.87 | Professional | 54 · Surgery only | $645.65 | $831.76 | $2,290.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $165.96 Typical High $457.09 | Professional | 55 · Aftercare only | $128.82 | $165.96 | $457.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $112.20 Typical High $309.03 | Professional | 56 · Pre-op care only | $85.11 | $112.20 | $309.03 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $407.38 Median $1,258.93 Typical High $2,951.21 | Professional | None | $407.38 | $1,258.93 | $2,951.21 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $891.25 Typical High $1,380.38 | Professional | 54 · Surgery only | $275.42 | $891.25 | $1,380.38 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $97.72 Typical High $151.36 | Professional | 55 · Aftercare only | $30.20 | $97.72 | $151.36 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $87.10 Typical High $131.83 | Professional | 56 · Pre-op care only | $26.92 | $87.10 | $131.83 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $1,548.82 Typical High $2,187.76 | Facility | None | $676.08 | $1,548.82 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $707.95 Median $891.25 Typical High $3,235.94 | Professional | None | $707.95 | $891.25 | $3,235.94 |
United Setting Facility Modifier None Typical Low $933.25 Median $3,548.13 Typical High $10,232.93 | Facility | None | $933.25 | $3,548.13 | $10,232.93 |
United Setting Professional Modifier None Typical Low $478.63 Median $1,047.13 Typical High $4,365.16 | Professional | None | $478.63 | $1,047.13 | $4,365.16 |
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 $426.58 Median $562.34 Typical High $1,548.82 | Professional | 52 · Reduced service | $426.58 | $562.34 | $1,548.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $223.87 Typical High $616.60 | Professional | 53 · Discontinued | $169.82 | $223.87 | $616.60 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $776.25 Typical High $2,137.96 | Professional | 78 · Unplanned return to OR | $602.56 | $776.25 | $2,137.96 |
Where Rhode Island sits
The same service costs 4.9 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· 40th of 51
$1,318
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.