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 $162.18 Median $223.87 Typical High $257.04 | Professional | None | $162.18 | $223.87 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $144.54 Typical High $194.98 | Professional | 54 · Surgery only | $123.03 | $144.54 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $28.84 Typical High $38.90 | Professional | 55 · Aftercare only | $24.55 | $28.84 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $19.50 Typical High $25.70 | Professional | 56 · Pre-op care only | $16.22 | $19.50 | $25.70 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $141.25 Median $229.09 Typical High $371.54 | Professional | None | $141.25 | $229.09 | $371.54 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $162.18 Typical High $234.42 | Professional | 54 · Surgery only | $93.33 | $162.18 | $234.42 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $20.42 Typical High $28.84 | Professional | 55 · Aftercare only | $11.75 | $20.42 | $28.84 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $20.42 Typical High $28.84 | Professional | 56 · Pre-op care only | $11.75 | $20.42 | $28.84 |
Cigna Setting Facility Modifier None Typical Low $199.53 Median $269.15 Typical High $1,202.26 | Facility | None | $199.53 | $269.15 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $263.03 Typical High $426.58 | Professional | None | $177.83 | $263.03 | $426.58 |
United Setting Facility Modifier None Typical Low $645.65 Median $1,445.44 Typical High $5,754.40 | Facility | None | $645.65 | $1,445.44 | $5,754.40 |
United Setting Professional Modifier None Typical Low $117.49 Median $186.21 Typical High $316.23 | Professional | None | $117.49 | $186.21 | $316.23 |
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 $81.28 Median $95.50 Typical High $128.82 | Professional | 52 · Reduced service | $81.28 | $95.50 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $38.90 Typical High $51.29 | Professional | 53 · Discontinued | $32.36 | $38.90 | $51.29 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $114.82 Median $134.90 Typical High $181.97 | Professional | 78 · Unplanned return to OR | $114.82 | $134.90 | $181.97 |
Where Rhode Island sits
The same service costs 3.8 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· 31st of 51
$224
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.