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 $223.87 Median $251.19 Typical High $309.03 | Professional | None | $223.87 | $251.19 | $309.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $194.98 Typical High $234.42 | Professional | 54 · Surgery only | $165.96 | $194.98 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $38.90 Typical High $46.77 | Professional | 55 · Aftercare only | $33.11 | $38.90 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $25.70 Typical High $30.90 | Professional | 56 · Pre-op care only | $22.39 | $25.70 | $30.90 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $186.21 Median $263.03 Typical High $416.87 | Professional | None | $186.21 | $263.03 | $416.87 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $173.78 Typical High $295.12 | Professional | 54 · Surgery only | $123.03 | $173.78 | $295.12 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $21.88 Typical High $37.15 | Professional | 55 · Aftercare only | $15.14 | $21.88 | $37.15 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $21.88 Typical High $37.15 | Professional | 56 · Pre-op care only | $15.14 | $21.88 | $37.15 |
Cigna Setting Facility Modifier None Typical Low $218.78 Median $295.12 Typical High $1,202.26 | Facility | None | $218.78 | $295.12 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $194.98 Median $281.84 Typical High $630.96 | Professional | None | $194.98 | $281.84 | $630.96 |
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 $177.83 Median $275.42 Typical High $524.81 | Professional | None | $177.83 | $275.42 | $524.81 |
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 $112.20 Median $128.82 Typical High $154.88 | Professional | 52 · Reduced service | $112.20 | $128.82 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $51.29 Typical High $63.10 | Professional | 53 · Discontinued | $44.67 | $51.29 | $63.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $154.88 Median $181.97 Typical High $218.78 | Professional | 78 · Unplanned return to OR | $154.88 | $181.97 | $218.78 |
Where Rhode Island sits
The same service costs 3.9 times more in Alaska than in Texas. 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
$282
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.