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 $3,715.35 Median $3,715.35 Typical High $3,981.07 | Facility | None | $3,715.35 | $3,715.35 | $3,981.07 |
Aetna Setting Professional Modifier None Typical Low $263.03 Median $316.23 Typical High $478.63 | Professional | None | $263.03 | $316.23 | $478.63 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $234.42 Typical High $354.81 | Professional | 54 · Surgery only | $194.98 | $234.42 | $354.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $46.77 Typical High $70.79 | Professional | 55 · Aftercare only | $38.90 | $46.77 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $31.62 Typical High $47.86 | Professional | 56 · Pre-op care only | $26.30 | $31.62 | $47.86 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $194.98 Median $346.74 Typical High $588.84 | Professional | None | $194.98 | $346.74 | $588.84 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $177.83 Typical High $309.03 | Professional | 54 · Surgery only | $114.82 | $177.83 | $309.03 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $47.86 Typical High $83.18 | Professional | 55 · Aftercare only | $30.90 | $47.86 | $83.18 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $25.12 Typical High $43.65 | Professional | 56 · Pre-op care only | $16.22 | $25.12 | $43.65 |
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 $204.17 Median $380.19 Typical High $870.96 | Professional | None | $204.17 | $380.19 | $870.96 |
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 $199.53 Median $363.08 Typical High $776.25 | Professional | None | $199.53 | $363.08 | $776.25 |
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 $131.83 Median $158.49 Typical High $239.88 | Professional | 52 · Reduced service | $131.83 | $158.49 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $63.10 Typical High $95.50 | Professional | 53 · Discontinued | $52.48 | $63.10 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $181.97 Median $218.78 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $181.97 | $218.78 | $331.13 |
Where Rhode Island sits
The same service costs 4.6 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
$355
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.