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 $169.82 Median $234.42 Typical High $302.00 | Professional | None | $169.82 | $234.42 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $162.18 Typical High $199.53 | Professional | 54 · Surgery only | $134.90 | $162.18 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $33.11 Typical High $39.81 | Professional | 55 · Aftercare only | $26.92 | $33.11 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $21.88 Typical High $26.92 | Professional | 56 · Pre-op care only | $18.20 | $21.88 | $26.92 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $151.36 Median $223.87 Typical High $354.81 | Professional | None | $151.36 | $223.87 | $354.81 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $100.00 Median $147.91 Typical High $239.88 | Professional | 54 · Surgery only | $100.00 | $147.91 | $239.88 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $18.62 Typical High $29.51 | Professional | 55 · Aftercare only | $12.30 | $18.62 | $29.51 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $18.62 Typical High $29.51 | Professional | 56 · Pre-op care only | $12.30 | $18.62 | $29.51 |
Cigna Setting Facility Modifier None Typical Low $194.98 Median $269.15 Typical High $794.33 | Facility | None | $194.98 | $269.15 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $239.88 Typical High $537.03 | Professional | None | $158.49 | $239.88 | $537.03 |
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 $144.54 Median $234.42 Typical High $457.09 | Professional | None | $144.54 | $234.42 | $457.09 |
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 $91.20 Median $109.65 Typical High $134.90 | Professional | 52 · Reduced service | $91.20 | $109.65 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $43.65 Typical High $53.70 | Professional | 53 · Discontinued | $36.31 | $43.65 | $53.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $125.89 Median $151.36 Typical High $186.21 | Professional | 78 · Unplanned return to OR | $125.89 | $151.36 | $186.21 |
Where Rhode Island sits
The same service costs 3.4 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· 35th of 51
$240
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.