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 $1,513.56 Median $1,548.82 Typical High $3,981.07 | Facility | None | $1,513.56 | $1,548.82 | $3,981.07 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $1,174.90 Typical High $1,230.27 | Professional | None | $537.03 | $1,174.90 | $1,230.27 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $870.96 Typical High $912.01 | Professional | 54 · Surgery only | $407.38 | $870.96 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $173.78 Typical High $181.97 | Professional | 55 · Aftercare only | $81.28 | $173.78 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $117.49 Typical High $123.03 | Professional | 56 · Pre-op care only | $53.70 | $117.49 | $123.03 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $501.19 Median $630.96 Typical High $933.25 | Professional | None | $501.19 | $630.96 | $933.25 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $416.87 Typical High $537.03 | Professional | 54 · Surgery only | $288.40 | $416.87 | $537.03 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $117.49 Typical High $154.88 | Professional | 55 · Aftercare only | $83.18 | $117.49 | $154.88 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $58.88 Typical High $77.62 | Professional | 56 · Pre-op care only | $41.69 | $58.88 | $77.62 |
Cigna Setting Facility Modifier None Typical Low $363.08 Median $478.63 Typical High $794.33 | Facility | None | $363.08 | $478.63 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $707.95 Median $891.25 Typical High $954.99 | Professional | None | $707.95 | $891.25 | $954.99 |
United Setting Facility Modifier None Typical Low $371.54 Median $1,096.48 Typical High $4,265.80 | Facility | None | $371.54 | $1,096.48 | $4,265.80 |
United Setting Professional Modifier None Typical Low $512.86 Median $891.25 Typical High $1,000.00 | Professional | None | $512.86 | $891.25 | $1,000.00 |
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 $269.15 Median $588.84 Typical High $616.60 | Professional | 52 · Reduced service | $269.15 | $588.84 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $234.42 Typical High $245.47 | Professional | 53 · Discontinued | $107.15 | $234.42 | $245.47 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $812.83 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $380.19 | $812.83 | $851.14 |
Where Rhode Island sits
The same service costs 6.2 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· 14th of 51
$891
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.