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 $741.31 Median $851.14 Typical High $851.14 | Professional | None | $741.31 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $630.96 Typical High $630.96 | Professional | 54 · Surgery only | $549.54 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $125.89 Typical High $125.89 | Professional | 55 · Aftercare only | $109.65 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $85.11 Typical High $85.11 | Professional | 56 · Pre-op care only | $74.13 | $85.11 | $85.11 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $851.14 Median $1,000.00 Typical High $1,288.25 | Professional | None | $851.14 | $1,000.00 | $1,288.25 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $707.95 Typical High $794.33 | Professional | 54 · Surgery only | $489.78 | $707.95 | $794.33 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $199.53 Typical High $223.87 | Professional | 55 · Aftercare only | $141.25 | $199.53 | $223.87 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $100.00 Typical High $112.20 | Professional | 56 · Pre-op care only | $70.79 | $100.00 | $112.20 |
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 $741.31 Median $1,584.89 Typical High $1,584.89 | Professional | None | $741.31 | $1,584.89 | $1,584.89 |
United Setting Facility Modifier None Typical Low $812.83 Median $2,630.27 Typical High $8,709.64 | Facility | None | $812.83 | $2,630.27 | $8,709.64 |
United Setting Professional Modifier None Typical Low $645.65 Median $707.95 Typical High $1,174.90 | Professional | None | $645.65 | $707.95 | $1,174.90 |
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 $371.54 Median $416.87 Typical High $416.87 | Professional | 52 · Reduced service | $371.54 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $169.82 Typical High $169.82 | Professional | 53 · Discontinued | $147.91 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $588.84 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $512.86 | $588.84 | $588.84 |
Where Rhode Island sits
The same service costs 8.3 times more in Wyoming 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· 30th of 51
$1,000
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.