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 $60.26 Median $120.23 Typical High $186.21 | Professional | None | $60.26 | $120.23 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $45.71 Median $74.13 Typical High $91.20 | Professional | 54 · Surgery only | $45.71 | $74.13 | $91.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $14.79 Typical High $18.20 | Professional | 55 · Aftercare only | $9.12 | $14.79 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $9.77 Typical High $12.02 | Professional | 56 · Pre-op care only | $6.03 | $9.77 | $12.02 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $83.18 Median $144.54 Typical High $234.42 | Professional | None | $83.18 | $144.54 | $234.42 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $54.95 Median $87.10 Typical High $138.04 | Professional | 54 · Surgery only | $54.95 | $87.10 | $138.04 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $6.92 Median $10.96 Typical High $17.38 | Professional | 55 · Aftercare only | $6.92 | $10.96 | $17.38 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $10.96 Typical High $17.38 | Professional | 56 · Pre-op care only | $6.92 | $10.96 | $17.38 |
Cigna Setting Facility Modifier None Typical Low $269.15 Median $269.15 Typical High $1,202.26 | Facility | None | $269.15 | $269.15 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $109.65 Median $204.17 Typical High $354.81 | Professional | None | $109.65 | $204.17 | $354.81 |
United Setting Facility Modifier None Typical Low $97.72 Median $316.23 Typical High $3,890.45 | Facility | None | $97.72 | $316.23 | $3,890.45 |
United Setting Professional Modifier None Typical Low $64.57 Median $131.83 Typical High $302.00 | Professional | None | $64.57 | $131.83 | $302.00 |
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 $30.20 Median $48.98 Typical High $60.26 | Professional | 52 · Reduced service | $30.20 | $48.98 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $19.50 Typical High $23.99 | Professional | 53 · Discontinued | $12.02 | $19.50 | $23.99 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $42.66 Median $69.18 Typical High $85.11 | Professional | 78 · Unplanned return to OR | $42.66 | $69.18 | $85.11 |
Where Rhode Island sits
The same service costs 4.5 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· 36th 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.