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 $2,089.30 Median $2,089.30 Typical High $2,089.30 | Professional | None | $2,089.30 | $2,089.30 | $2,089.30 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,584.89 Median $1,584.89 Typical High $1,584.89 | Professional | 54 · Surgery only | $1,584.89 | $1,584.89 | $1,584.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $316.23 Median $316.23 Typical High $316.23 | Professional | 55 · Aftercare only | $316.23 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $208.93 Median $208.93 Typical High $208.93 | Professional | 56 · Pre-op care only | $208.93 | $208.93 | $208.93 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $1,288.25 Median $1,737.80 Typical High $2,884.03 | Professional | None | $1,288.25 | $1,737.80 | $2,884.03 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $1,174.90 Typical High $1,995.26 | Professional | 54 · Surgery only | $831.76 | $1,174.90 | $1,995.26 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $147.91 Typical High $245.47 | Professional | 55 · Aftercare only | $102.33 | $147.91 | $245.47 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $147.91 Typical High $245.47 | Professional | 56 · Pre-op care only | $102.33 | $147.91 | $245.47 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $3,548.13 Typical High $5,128.61 | Facility | None | $676.08 | $3,548.13 | $5,128.61 |
Cigna Setting Professional Modifier None Typical Low $1,905.46 Median $2,630.27 Typical High $3,019.95 | Professional | None | $1,905.46 | $2,630.27 | $3,019.95 |
United Setting Facility Modifier None Typical Low $933.25 Median $3,548.13 Typical High $11,748.98 | Facility | None | $933.25 | $3,548.13 | $11,748.98 |
United Setting Professional Modifier None Typical Low $1,288.25 Median $1,819.70 Typical High $2,511.89 | Professional | None | $1,288.25 | $1,819.70 | $2,511.89 |
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 $1,047.13 Median $1,047.13 Typical High $1,047.13 | Professional | 52 · Reduced service | $1,047.13 | $1,047.13 | $1,047.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $416.87 Median $416.87 Typical High $416.87 | Professional | 53 · Discontinued | $416.87 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,479.11 Median $1,479.11 Typical High $1,479.11 | Professional | 78 · Unplanned return to OR | $1,479.11 | $1,479.11 | $1,479.11 |
Where Rhode Island sits
The same service costs 5.8 times more in Alaska 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· 24th of 51
$2,089
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.