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 $2,398.83 Median $3,235.94 Typical High $3,981.07 | Facility | None | $2,398.83 | $3,235.94 | $3,981.07 |
Aetna Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,000.00 | Professional | None | $1,000.00 | $1,000.00 | $1,000.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $741.31 Typical High $741.31 | Professional | 54 · Surgery only | $741.31 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | 55 · Aftercare only | $151.36 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | 56 · Pre-op care only | $100.00 | $100.00 | $100.00 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $691.83 Median $933.25 Typical High $1,548.82 | Professional | None | $691.83 | $933.25 | $1,548.82 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $630.96 Typical High $1,047.13 | Professional | 54 · Surgery only | $436.52 | $630.96 | $1,047.13 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $79.43 Typical High $131.83 | Professional | 55 · Aftercare only | $54.95 | $79.43 | $131.83 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $79.43 Typical High $131.83 | Professional | 56 · Pre-op care only | $54.95 | $79.43 | $131.83 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $2,238.72 Typical High $3,235.94 | Facility | None | $676.08 | $2,238.72 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $1,000.00 Median $1,380.38 Typical High $1,584.89 | Professional | None | $1,000.00 | $1,380.38 | $1,584.89 |
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 $676.08 Median $954.99 Typical High $1,348.96 | Professional | None | $676.08 | $954.99 | $1,348.96 |
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 $501.19 Median $501.19 Typical High $501.19 | Professional | 52 · Reduced service | $501.19 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $199.53 Typical High $199.53 | Professional | 53 · Discontinued | $199.53 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $691.83 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $691.83 | $691.83 | $691.83 |
Where Rhode Island sits
The same service costs 7.9 times more in Oklahoma than in Utah. 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· 34th of 51
$1,000
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.