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 $1,122.02 Median $1,122.02 Typical High $1,122.02 | Professional | None | $1,122.02 | $1,122.02 | $1,122.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $831.76 Typical High $831.76 | Professional | 54 · Surgery only | $831.76 | $831.76 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | 55 · Aftercare only | $165.96 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $112.20 Typical High $112.20 | Professional | 56 · Pre-op care only | $112.20 | $112.20 | $112.20 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $758.58 Median $1,023.29 Typical High $1,698.24 | Professional | None | $758.58 | $1,023.29 | $1,698.24 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $691.83 Typical High $1,148.15 | Professional | 54 · Surgery only | $478.63 | $691.83 | $1,148.15 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $85.11 Typical High $141.25 | Professional | 55 · Aftercare only | $60.26 | $85.11 | $141.25 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $85.11 Typical High $141.25 | Professional | 56 · Pre-op care only | $60.26 | $85.11 | $141.25 |
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 $1,096.48 Median $1,513.56 Typical High $1,737.80 | Professional | None | $1,096.48 | $1,513.56 | $1,737.80 |
United Setting Facility Modifier None Typical Low $812.83 Median $2,630.27 Typical High $7,762.47 | Facility | None | $812.83 | $2,630.27 | $7,762.47 |
United Setting Professional Modifier None Typical Low $741.31 Median $1,047.13 Typical High $1,445.44 | Professional | None | $741.31 | $1,047.13 | $1,445.44 |
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 $549.54 Median $549.54 Typical High $549.54 | Professional | 52 · Reduced service | $549.54 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $223.87 Typical High $223.87 | Professional | 53 · Discontinued | $223.87 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $776.25 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $776.25 | $776.25 | $776.25 |
Where Rhode Island sits
The same service costs 6.6 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· 32nd of 51
$1,122
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.