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 $380.19 Median $416.87 Typical High $416.87 | Professional | None | $380.19 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $309.03 Typical High $309.03 | Professional | 54 · Surgery only | $288.40 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $63.10 Typical High $63.10 | Professional | 55 · Aftercare only | $57.54 | $63.10 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $41.69 Typical High $41.69 | Professional | 56 · Pre-op care only | $38.02 | $41.69 | $41.69 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $380.19 Median $446.68 Typical High $645.65 | Professional | None | $380.19 | $446.68 | $645.65 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $316.23 Typical High $398.11 | Professional | 54 · Surgery only | $218.78 | $316.23 | $398.11 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $89.13 Typical High $112.20 | Professional | 55 · Aftercare only | $63.10 | $89.13 | $112.20 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $44.67 Typical High $56.23 | Professional | 56 · Pre-op care only | $31.62 | $44.67 | $56.23 |
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 $389.05 Median $691.83 Typical High $691.83 | Professional | None | $389.05 | $691.83 | $691.83 |
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 $295.12 Median $407.38 Typical High $588.84 | Professional | None | $295.12 | $407.38 | $588.84 |
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 $190.55 Median $208.93 Typical High $208.93 | Professional | 52 · Reduced service | $190.55 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $83.18 Typical High $83.18 | Professional | 53 · Discontinued | $75.86 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $269.15 Median $288.40 Typical High $288.40 | Professional | 78 · Unplanned return to OR | $269.15 | $288.40 | $288.40 |
Where Rhode Island sits
The same service costs 6.9 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· 33rd of 51
$447
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.