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 $3,715.35 Median $3,715.35 Typical High $3,981.07 | Facility | None | $3,715.35 | $3,715.35 | $3,981.07 |
Aetna Setting Professional Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $2,454.71 | Professional | None | $2,454.71 | $2,454.71 | $2,454.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,862.09 Median $1,862.09 Typical High $1,862.09 | Professional | 54 · Surgery only | $1,862.09 | $1,862.09 | $1,862.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $371.54 Median $371.54 Typical High $371.54 | Professional | 55 · Aftercare only | $371.54 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $245.47 Median $245.47 Typical High $245.47 | Professional | 56 · Pre-op care only | $245.47 | $245.47 | $245.47 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $2,238.72 Median $2,951.21 Typical High $3,890.45 | Professional | None | $2,238.72 | $2,951.21 | $3,890.45 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $1,348.96 Median $1,905.46 Typical High $2,570.40 | Professional | 54 · Surgery only | $1,348.96 | $1,905.46 | $2,570.40 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $323.59 Typical High $436.52 | Professional | 55 · Aftercare only | $229.09 | $323.59 | $436.52 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $194.98 Median $275.42 Typical High $371.54 | Professional | 56 · Pre-op care only | $194.98 | $275.42 | $371.54 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $676.08 Typical High $1,202.26 | Facility | None | $50.12 | $676.08 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $3,311.31 Median $4,073.80 Typical High $5,128.61 | Professional | None | $3,311.31 | $4,073.80 | $5,128.61 |
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 $2,187.76 Median $2,754.23 Typical High $4,265.80 | Professional | None | $2,187.76 | $2,754.23 | $4,265.80 |
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 $1,230.27 Median $1,230.27 Typical High $1,230.27 | Professional | 52 · Reduced service | $1,230.27 | $1,230.27 | $1,230.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $489.78 Median $489.78 Typical High $489.78 | Professional | 53 · Discontinued | $489.78 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,737.80 Median $1,737.80 Typical High $1,737.80 | Professional | 78 · Unplanned return to OR | $1,737.80 | $1,737.80 | $1,737.80 |
Where Rhode Island sits
The same service costs 6.0 times more in Alaska than in Texas. 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· 26th of 51
$2,951
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.