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 $3,467.37 Median $3,715.35 Typical High $3,981.07 | Facility | None | $3,467.37 | $3,715.35 | $3,981.07 |
Aetna Setting Professional Modifier None Typical Low $512.86 Median $562.34 Typical High $562.34 | Professional | None | $512.86 | $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 $51.29 Median $56.23 Typical High $56.23 | Professional | 56 · Pre-op care only | $51.29 | $56.23 | $56.23 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $512.86 Median $602.56 Typical High $851.14 | Professional | None | $512.86 | $602.56 | $851.14 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $416.87 Typical High $524.81 | Professional | 54 · Surgery only | $295.12 | $416.87 | $524.81 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $120.23 Typical High $151.36 | Professional | 55 · Aftercare only | $83.18 | $120.23 | $151.36 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $60.26 Typical High $75.86 | Professional | 56 · Pre-op care only | $41.69 | $60.26 | $75.86 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $2,238.72 Typical High $3,235.94 | Facility | None | $954.99 | $2,238.72 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $524.81 Median $912.01 Typical High $912.01 | Professional | None | $524.81 | $912.01 | $912.01 |
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 $478.63 Median $562.34 Typical High $707.95 | Professional | None | $478.63 | $562.34 | $707.95 |
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 $281.84 Typical High $281.84 | Professional | 52 · Reduced service | $251.19 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $112.20 Typical High $112.20 | Professional | 53 · Discontinued | $102.33 | $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· 36th of 51
$603
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.