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 $72.44 Median $107.15 Typical High $147.91 | Professional | None | $72.44 | $107.15 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $54.95 Median $66.07 Typical High $87.10 | Professional | 54 · Surgery only | $54.95 | $66.07 | $87.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $13.49 Typical High $17.38 | Professional | 55 · Aftercare only | $10.96 | $13.49 | $17.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $8.91 Typical High $11.48 | Professional | 56 · Pre-op care only | $7.24 | $8.91 | $11.48 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $58.88 Median $95.50 Typical High $162.18 | Professional | None | $58.88 | $95.50 | $162.18 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $38.90 Median $63.10 Typical High $95.50 | Professional | 54 · Surgery only | $38.90 | $63.10 | $95.50 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $4.90 Median $7.94 Typical High $12.02 | Professional | 55 · Aftercare only | $4.90 | $7.94 | $12.02 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $4.90 Median $7.94 Typical High $12.02 | Professional | 56 · Pre-op care only | $4.90 | $7.94 | $12.02 |
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 $63.10 Median $109.65 Typical High $234.42 | Professional | None | $63.10 | $109.65 | $234.42 |
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 $54.95 Median $97.72 Typical High $199.53 | Professional | None | $54.95 | $97.72 | $199.53 |
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 $36.31 Median $44.67 Typical High $57.54 | Professional | 52 · Reduced service | $36.31 | $44.67 | $57.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $17.78 Typical High $23.44 | Professional | 53 · Discontinued | $14.45 | $17.78 | $23.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $51.29 Median $61.66 Typical High $81.28 | Professional | 78 · Unplanned return to OR | $51.29 | $61.66 | $81.28 |
Where Rhode Island sits
The same service costs 3.9 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· 37th of 51
$105
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.