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 $501.19 Median $501.19 Typical High $501.19 | Professional | None | $501.19 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $371.54 Typical High $371.54 | Professional | 54 · Surgery only | $371.54 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $74.13 Typical High $74.13 | Professional | 55 · Aftercare only | $74.13 | $74.13 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | 56 · Pre-op care only | $50.12 | $50.12 | $50.12 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $380.19 Median $512.86 Typical High $812.83 | Professional | None | $380.19 | $512.86 | $812.83 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $257.04 Typical High $416.87 | Professional | 54 · Surgery only | $181.97 | $257.04 | $416.87 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $100.00 Typical High $158.49 | Professional | 55 · Aftercare only | $69.18 | $100.00 | $158.49 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $74.13 Typical High $117.49 | Professional | 56 · Pre-op care only | $51.29 | $74.13 | $117.49 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $588.84 Typical High $1,071.52 | Facility | None | $50.12 | $588.84 | $1,071.52 |
Cigna Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $891.25 | Professional | None | $436.52 | $436.52 | $891.25 |
United Setting Facility Modifier None Typical Low $426.58 Median $1,513.56 Typical High $6,456.54 | Facility | None | $426.58 | $1,513.56 | $6,456.54 |
United Setting Professional Modifier None Typical Low $338.84 Median $457.09 Typical High $741.31 | Professional | None | $338.84 | $457.09 | $741.31 |
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 $245.47 Median $245.47 Typical High $245.47 | Professional | 52 · Reduced service | $245.47 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | 53 · Discontinued | $100.00 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $346.74 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $346.74 | $346.74 | $346.74 |
Where Rhode Island sits
The same service costs 6.0 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· 37th of 51
$501
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.