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 $134.90 Median $190.55 Typical High $223.87 | Professional | None | $134.90 | $190.55 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $131.83 Typical High $162.18 | Professional | 54 · Surgery only | $109.65 | $131.83 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $26.30 Typical High $32.36 | Professional | 55 · Aftercare only | $21.88 | $26.30 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $17.38 Typical High $21.38 | Professional | 56 · Pre-op care only | $14.79 | $17.38 | $21.38 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $112.20 Median $177.83 Typical High $288.40 | Professional | None | $112.20 | $177.83 | $288.40 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $74.13 Median $114.82 Typical High $190.55 | Professional | 54 · Surgery only | $74.13 | $114.82 | $190.55 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $14.45 Typical High $23.99 | Professional | 55 · Aftercare only | $9.12 | $14.45 | $23.99 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $14.45 Typical High $23.99 | Professional | 56 · Pre-op care only | $9.12 | $14.45 | $23.99 |
Cigna Setting Facility Modifier None Typical Low $158.49 Median $208.93 Typical High $1,202.26 | Facility | None | $158.49 | $208.93 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $199.53 Typical High $436.52 | Professional | None | $120.23 | $199.53 | $436.52 |
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 $117.49 Median $186.21 Typical High $363.08 | Professional | None | $117.49 | $186.21 | $363.08 |
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 $74.13 Median $87.10 Typical High $107.15 | Professional | 52 · Reduced service | $74.13 | $87.10 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $34.67 Typical High $42.66 | Professional | 53 · Discontinued | $29.51 | $34.67 | $42.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $102.33 Median $123.03 Typical High $151.36 | Professional | 78 · Unplanned return to OR | $102.33 | $123.03 | $151.36 |
Where Rhode Island sits
The same service costs 3.5 times more in Alaska than in Maryland. 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
$191
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.