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 $104.71 Median $138.04 Typical High $199.53 | Professional | None | $104.71 | $138.04 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $79.43 Median $85.11 Typical High $102.33 | Professional | 54 · Surgery only | $79.43 | $85.11 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $16.98 Typical High $20.42 | Professional | 55 · Aftercare only | $15.85 | $16.98 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $11.48 Typical High $13.80 | Professional | 56 · Pre-op care only | $10.47 | $11.48 | $13.80 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $97.72 Median $125.89 Typical High $199.53 | Professional | None | $97.72 | $125.89 | $199.53 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $63.10 Median $89.13 Typical High $141.25 | Professional | 54 · Surgery only | $63.10 | $89.13 | $141.25 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $11.22 Typical High $17.38 | Professional | 55 · Aftercare only | $7.94 | $11.22 | $17.38 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $11.22 Typical High $17.38 | Professional | 56 · Pre-op care only | $7.94 | $11.22 | $17.38 |
Cigna Setting Facility Modifier None Typical Low $125.89 Median $169.82 Typical High $794.33 | Facility | None | $125.89 | $169.82 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $100.00 Median $138.04 Typical High $295.12 | Professional | None | $100.00 | $138.04 | $295.12 |
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 $85.11 Median $141.25 Typical High $245.47 | Professional | None | $85.11 | $141.25 | $245.47 |
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 $52.48 Median $57.54 Typical High $69.18 | Professional | 52 · Reduced service | $52.48 | $57.54 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $22.91 Typical High $27.54 | Professional | 53 · Discontinued | $20.89 | $22.91 | $27.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $74.13 Median $79.43 Typical High $95.50 | Professional | 78 · Unplanned return to OR | $74.13 | $79.43 | $95.50 |
Where Rhode Island sits
The same service costs 4.1 times more in Alaska than in Kentucky. 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
$138
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.