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 $562.34 Typical High $562.34 | Professional | None | $501.19 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $416.87 Typical High $416.87 | Professional | 54 · Surgery only | $380.19 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $83.18 Typical High $83.18 | Professional | 55 · Aftercare only | $75.86 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $56.23 Typical High $56.23 | Professional | 56 · Pre-op care only | $50.12 | $56.23 | $56.23 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $501.19 Median $588.84 Typical High $851.14 | Professional | None | $501.19 | $588.84 | $851.14 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $416.87 Typical High $524.81 | Professional | 54 · Surgery only | $288.40 | $416.87 | $524.81 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $117.49 Typical High $151.36 | Professional | 55 · Aftercare only | $83.18 | $117.49 | $151.36 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $58.88 Typical High $75.86 | Professional | 56 · Pre-op care only | $41.69 | $58.88 | $75.86 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $2,884.03 Typical High $4,073.80 | Facility | None | $588.84 | $2,884.03 | $4,073.80 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $891.25 Typical High $891.25 | Professional | None | $512.86 | $891.25 | $891.25 |
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 $398.11 Median $489.78 Typical High $776.25 | Professional | None | $398.11 | $489.78 | $776.25 |
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 $251.19 Median $275.42 Typical High $275.42 | Professional | 52 · Reduced service | $251.19 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $112.20 Typical High $112.20 | Professional | 53 · Discontinued | $100.00 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $389.05 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $354.81 | $389.05 | $389.05 |
Where Rhode Island sits
The same service costs 7.9 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· 34th of 51
$589
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.