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 $125.89 Median $158.49 Typical High $199.53 | Professional | None | $125.89 | $158.49 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $114.82 Typical High $147.91 | Professional | 54 · Surgery only | $93.33 | $114.82 | $147.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $22.91 Typical High $29.51 | Professional | 55 · Aftercare only | $18.62 | $22.91 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $15.49 Typical High $19.95 | Professional | 56 · Pre-op care only | $12.59 | $15.49 | $19.95 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $109.65 Median $177.83 Typical High $281.84 | Professional | None | $109.65 | $177.83 | $281.84 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $72.44 Median $114.82 Typical High $169.82 | Professional | 54 · Surgery only | $72.44 | $114.82 | $169.82 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $14.45 Typical High $21.38 | Professional | 55 · Aftercare only | $9.12 | $14.45 | $21.38 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $14.45 Typical High $21.38 | Professional | 56 · Pre-op care only | $9.12 | $14.45 | $21.38 |
Cigna Setting Facility Modifier None Typical Low $165.96 Median $229.09 Typical High $794.33 | Facility | None | $165.96 | $229.09 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $114.82 Median $190.55 Typical High $416.87 | Professional | None | $114.82 | $190.55 | $416.87 |
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 $95.50 Median $169.82 Typical High $354.81 | Professional | None | $95.50 | $169.82 | $354.81 |
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 $61.66 Median $75.86 Typical High $97.72 | Professional | 52 · Reduced service | $61.66 | $75.86 | $97.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $30.90 Typical High $39.81 | Professional | 53 · Discontinued | $25.12 | $30.90 | $39.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $87.10 Median $107.15 Typical High $138.04 | Professional | 78 · Unplanned return to OR | $87.10 | $107.15 | $138.04 |
Where Rhode Island sits
The same service costs 3.6 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· 32nd of 51
$186
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.