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 $489.78 Median $537.03 Typical High $537.03 | Professional | None | $489.78 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $398.11 Typical High $398.11 | Professional | 54 · Surgery only | $371.54 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $81.28 Typical High $81.28 | Professional | 55 · Aftercare only | $74.13 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $53.70 Typical High $53.70 | Professional | 56 · Pre-op care only | $48.98 | $53.70 | $53.70 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $380.19 Median $489.78 Typical High $741.31 | Professional | None | $380.19 | $489.78 | $741.31 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $288.40 Typical High $371.54 | Professional | 54 · Surgery only | $239.88 | $288.40 | $371.54 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $87.10 Typical High $112.20 | Professional | 55 · Aftercare only | $72.44 | $87.10 | $112.20 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $41.69 Typical High $53.70 | Professional | 56 · Pre-op care only | $34.67 | $41.69 | $53.70 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $1,148.15 Typical High $1,621.81 | Facility | None | $446.68 | $1,148.15 | $1,621.81 |
Cigna Setting Professional Modifier None Typical Low $588.84 Median $707.95 Typical High $831.76 | Professional | None | $588.84 | $707.95 | $831.76 |
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 $323.59 Median $407.38 Typical High $776.25 | Professional | None | $323.59 | $407.38 | $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 $245.47 Median $269.15 Typical High $269.15 | Professional | 52 · Reduced service | $245.47 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $107.15 Typical High $107.15 | Professional | 53 · Discontinued | $97.72 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $371.54 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $346.74 | $371.54 | $371.54 |
Where Rhode Island sits
The same service costs 5.4 times more in Alaska than in Utah. 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· 26th of 51
$537
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.