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 $354.81 Median $389.05 Typical High $389.05 | Professional | None | $354.81 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $288.40 Typical High $288.40 | Professional | 54 · Surgery only | $263.03 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $57.54 Typical High $57.54 | Professional | 55 · Aftercare only | $52.48 | $57.54 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $38.90 Typical High $38.90 | Professional | 56 · Pre-op care only | $35.48 | $38.90 | $38.90 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $269.15 Median $354.81 Typical High $524.81 | Professional | None | $269.15 | $354.81 | $524.81 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $208.93 Typical High $269.15 | Professional | 54 · Surgery only | $173.78 | $208.93 | $269.15 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $64.57 Typical High $81.28 | Professional | 55 · Aftercare only | $52.48 | $64.57 | $81.28 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $30.20 Typical High $38.90 | Professional | 56 · Pre-op care only | $25.12 | $30.20 | $38.90 |
Cigna Setting Facility Modifier None Typical Low $162.18 Median $218.78 Typical High $1,202.26 | Facility | None | $162.18 | $218.78 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $436.52 Median $512.86 Typical High $602.56 | Professional | None | $436.52 | $512.86 | $602.56 |
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 $234.42 Median $302.00 Typical High $549.54 | Professional | None | $234.42 | $302.00 | $549.54 |
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 $177.83 Median $194.98 Typical High $194.98 | Professional | 52 · Reduced service | $177.83 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $77.62 Typical High $77.62 | Professional | 53 · Discontinued | $70.79 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $269.15 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $245.47 | $269.15 | $269.15 |
Where Rhode Island sits
The same service costs 5.8 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· 24th of 51
$389
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.