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 $131.83 Median $186.21 Typical High $257.04 | Professional | None | $131.83 | $186.21 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $141.25 Typical High $190.55 | Professional | 54 · Surgery only | $97.72 | $141.25 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $28.18 Typical High $38.02 | Professional | 55 · Aftercare only | $19.50 | $28.18 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $18.62 Typical High $25.70 | Professional | 56 · Pre-op care only | $13.18 | $18.62 | $25.70 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $125.89 Median $239.88 Typical High $407.38 | Professional | None | $125.89 | $239.88 | $407.38 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $165.96 Typical High $251.19 | Professional | 54 · Surgery only | $83.18 | $165.96 | $251.19 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $20.89 Typical High $31.62 | Professional | 55 · Aftercare only | $10.23 | $20.89 | $31.62 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $20.89 Typical High $31.62 | Professional | 56 · Pre-op care only | $10.23 | $20.89 | $31.62 |
Cigna Setting Facility Modifier None Typical Low $154.88 Median $208.93 Typical High $1,202.26 | Facility | None | $154.88 | $208.93 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $288.40 Typical High $457.09 | Professional | None | $199.53 | $288.40 | $457.09 |
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 $208.93 Typical High $363.08 | Professional | None | $117.49 | $208.93 | $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 $66.07 Median $93.33 Typical High $128.82 | Professional | 52 · Reduced service | $66.07 | $93.33 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $37.15 Typical High $51.29 | Professional | 53 · Discontinued | $26.30 | $37.15 | $51.29 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $91.20 Median $131.83 Typical High $177.83 | Professional | 78 · Unplanned return to OR | $91.20 | $131.83 | $177.83 |
Where Rhode Island sits
The same service costs 3.6 times more in Wisconsin than in Kentucky. 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
$229
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.