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 $3,715.35 Median $3,715.35 Typical High $3,981.07 | Facility | None | $3,715.35 | $3,715.35 | $3,981.07 |
Aetna Setting Professional Modifier None Typical Low $138.04 Median $229.09 Typical High $251.19 | Professional | None | $138.04 | $229.09 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $102.33 Median $144.54 Typical High $190.55 | Professional | 54 · Surgery only | $102.33 | $144.54 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $28.84 Typical High $38.02 | Professional | 55 · Aftercare only | $20.42 | $28.84 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $19.05 Typical High $25.12 | Professional | 56 · Pre-op care only | $13.80 | $19.05 | $25.12 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $123.03 Median $208.93 Typical High $407.38 | Professional | None | $123.03 | $208.93 | $407.38 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $138.04 Typical High $208.93 | Professional | 54 · Surgery only | $81.28 | $138.04 | $208.93 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $17.38 Typical High $25.70 | Professional | 55 · Aftercare only | $10.23 | $17.38 | $25.70 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $17.38 Typical High $25.70 | Professional | 56 · Pre-op care only | $10.23 | $17.38 | $25.70 |
Cigna Setting Facility Modifier None Typical Low $269.15 Median $269.15 Typical High $1,202.26 | Facility | None | $269.15 | $269.15 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $275.42 Typical High $398.11 | Professional | None | $177.83 | $275.42 | $398.11 |
United Setting Facility Modifier None Typical Low $97.72 Median $295.12 Typical High $3,890.45 | Facility | None | $97.72 | $295.12 | $3,890.45 |
United Setting Professional Modifier None Typical Low $120.23 Median $199.53 Typical High $323.59 | Professional | None | $120.23 | $199.53 | $323.59 |
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 $67.61 Median $95.50 Typical High $125.89 | Professional | 52 · Reduced service | $67.61 | $95.50 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $38.02 Typical High $50.12 | Professional | 53 · Discontinued | $27.54 | $38.02 | $50.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $95.50 Median $134.90 Typical High $177.83 | Professional | 78 · Unplanned return to OR | $95.50 | $134.90 | $177.83 |
Where Rhode Island sits
The same service costs 4.5 times more in Alaska 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· 32nd of 51
$209
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.