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 $3,715.35 Median $3,981.07 Typical High $5,495.41 | Facility | None | $3,715.35 | $3,981.07 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $1,548.82 | Professional | None | $1,548.82 | $1,548.82 | $1,548.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,148.15 Typical High $1,148.15 | Professional | 54 · Surgery only | $1,148.15 | $1,148.15 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | 55 · Aftercare only | $229.09 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | 56 · Pre-op care only | $154.88 | $154.88 | $154.88 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $1,148.15 Median $1,548.82 Typical High $2,570.40 | Professional | None | $1,148.15 | $1,548.82 | $2,570.40 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $1,023.29 Typical High $1,698.24 | Professional | 54 · Surgery only | $724.44 | $1,023.29 | $1,698.24 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $181.97 Typical High $302.00 | Professional | 55 · Aftercare only | $128.82 | $181.97 | $302.00 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $91.20 Typical High $151.36 | Professional | 56 · Pre-op care only | $64.57 | $91.20 | $151.36 |
Cigna Setting Facility Modifier None Typical Low $1,318.26 Median $3,981.07 Typical High $5,623.41 | Facility | None | $1,318.26 | $3,981.07 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $1,659.59 Median $2,187.76 Typical High $2,630.27 | Professional | None | $1,659.59 | $2,187.76 | $2,630.27 |
United Setting Facility Modifier None Typical Low $933.25 Median $3,548.13 Typical High $12,589.25 | Facility | None | $933.25 | $3,548.13 | $12,589.25 |
United Setting Professional Modifier None Typical Low $1,096.48 Median $1,412.54 Typical High $2,238.72 | Professional | None | $1,096.48 | $1,412.54 | $2,238.72 |
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 $776.25 Median $776.25 Typical High $776.25 | Professional | 52 · Reduced service | $776.25 | $776.25 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $309.03 Median $309.03 Typical High $309.03 | Professional | 53 · Discontinued | $309.03 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,071.52 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,071.52 | $1,071.52 |
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· 36th of 51
$1,549
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.