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 $245.47 Median $275.42 Typical High $275.42 | Professional | None | $245.47 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $204.17 Typical High $204.17 | Professional | 54 · Surgery only | $181.97 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $40.74 Typical High $40.74 | Professional | 55 · Aftercare only | $36.31 | $40.74 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $26.92 Typical High $27.54 | Professional | 56 · Pre-op care only | $24.55 | $26.92 | $27.54 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $186.21 Median $239.88 Typical High $371.54 | Professional | None | $186.21 | $239.88 | $371.54 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $141.25 Typical High $181.97 | Professional | 54 · Surgery only | $114.82 | $141.25 | $181.97 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $42.66 Typical High $54.95 | Professional | 55 · Aftercare only | $35.48 | $42.66 | $54.95 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $20.42 Typical High $26.30 | Professional | 56 · Pre-op care only | $16.60 | $20.42 | $26.30 |
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 $302.00 Median $346.74 Typical High $407.38 | Professional | None | $302.00 | $346.74 | $407.38 |
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 $158.49 Median $213.80 Typical High $380.19 | Professional | None | $158.49 | $213.80 | $380.19 |
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 $123.03 Median $134.90 Typical High $138.04 | Professional | 52 · Reduced service | $123.03 | $134.90 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $53.70 Typical High $54.95 | Professional | 53 · Discontinued | $48.98 | $53.70 | $54.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $169.82 Median $190.55 Typical High $190.55 | Professional | 78 · Unplanned return to OR | $169.82 | $190.55 | $190.55 |
Where Rhode Island sits
The same service costs 4.8 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· 26th of 51
$263
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.