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 $3,019.95 Median $3,715.35 Typical High $3,981.07 | Facility | None | $3,019.95 | $3,715.35 | $3,981.07 |
Aetna Setting Professional Modifier None Typical Low $549.54 Median $602.56 Typical High $707.95 | Professional | None | $549.54 | $602.56 | $707.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $446.68 Typical High $446.68 | Professional | 54 · Surgery only | $446.68 | $446.68 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $89.13 Typical High $89.13 | Professional | 55 · Aftercare only | $89.13 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | 56 · Pre-op care only | $60.26 | $60.26 | $60.26 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $426.58 Median $562.34 Typical High $933.25 | Professional | None | $426.58 | $562.34 | $933.25 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $380.19 Typical High $630.96 | Professional | 54 · Surgery only | $269.15 | $380.19 | $630.96 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $47.86 Typical High $79.43 | Professional | 55 · Aftercare only | $33.88 | $47.86 | $79.43 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $47.86 Typical High $79.43 | Professional | 56 · Pre-op care only | $33.88 | $47.86 | $79.43 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $2,238.72 Typical High $3,235.94 | Facility | None | $831.76 | $2,238.72 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $588.84 Median $851.14 Typical High $954.99 | Professional | None | $588.84 | $851.14 | $954.99 |
United Setting Facility Modifier None Typical Low $870.96 Median $2,089.30 Typical High $7,413.10 | Facility | None | $870.96 | $2,089.30 | $7,413.10 |
United Setting Professional Modifier None Typical Low $416.87 Median $537.03 Typical High $812.83 | Professional | None | $416.87 | $537.03 | $812.83 |
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 $302.00 Median $302.00 Typical High $302.00 | Professional | 52 · Reduced service | $302.00 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | 53 · Discontinued | $120.23 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $416.87 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $416.87 | $416.87 | $416.87 |
Where Rhode Island sits
The same service costs 8.7 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· 35th of 51
$603
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.