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 $2,089.30 Median $2,754.23 Typical High $3,981.07 | Facility | None | $2,089.30 | $2,754.23 | $3,981.07 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $218.78 Typical High $251.19 | Professional | None | $186.21 | $218.78 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $165.96 Typical High $190.55 | Professional | 54 · Surgery only | $141.25 | $165.96 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $33.11 Typical High $38.02 | Professional | 55 · Aftercare only | $28.18 | $33.11 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $21.88 Typical High $25.12 | Professional | 56 · Pre-op care only | $18.62 | $21.88 | $25.12 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $151.36 Median $223.87 Typical High $309.03 | Professional | None | $151.36 | $223.87 | $309.03 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $100.00 Median $147.91 Typical High $208.93 | Professional | 54 · Surgery only | $100.00 | $147.91 | $208.93 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $18.20 Typical High $26.30 | Professional | 55 · Aftercare only | $12.59 | $18.20 | $26.30 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $18.20 Typical High $26.30 | Professional | 56 · Pre-op care only | $12.59 | $18.20 | $26.30 |
Cigna Setting Facility Modifier None Typical Low $190.55 Median $263.03 Typical High $794.33 | Facility | None | $190.55 | $263.03 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $263.03 Median $302.00 Typical High $389.05 | Professional | None | $263.03 | $302.00 | $389.05 |
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 $125.89 Median $190.55 Typical High $354.81 | Professional | None | $125.89 | $190.55 | $354.81 |
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 $93.33 Median $109.65 Typical High $125.89 | Professional | 52 · Reduced service | $93.33 | $109.65 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $43.65 Typical High $51.29 | Professional | 53 · Discontinued | $37.15 | $43.65 | $51.29 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $131.83 Median $154.88 Typical High $177.83 | Professional | 78 · Unplanned return to OR | $131.83 | $154.88 | $177.83 |
Where Rhode Island sits
The same service costs 3.5 times more in Alaska than in Florida. 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· 23rd of 51
$251
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.