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 $218.78 Median $263.03 Typical High $338.84 | Professional | None | $218.78 | $263.03 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $199.53 Typical High $251.19 | Professional | 54 · Surgery only | $165.96 | $199.53 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $39.81 Typical High $50.12 | Professional | 55 · Aftercare only | $33.11 | $39.81 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $26.30 Typical High $33.88 | Professional | 56 · Pre-op care only | $21.88 | $26.30 | $33.88 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $190.55 Median $295.12 Typical High $467.74 | Professional | None | $190.55 | $295.12 | $467.74 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $190.55 Typical High $288.40 | Professional | 54 · Surgery only | $125.89 | $190.55 | $288.40 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $23.99 Typical High $36.31 | Professional | 55 · Aftercare only | $15.49 | $23.99 | $36.31 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $23.99 Typical High $36.31 | Professional | 56 · Pre-op care only | $15.49 | $23.99 | $36.31 |
Cigna Setting Facility Modifier None Typical Low $245.47 Median $331.13 Typical High $794.33 | Facility | None | $245.47 | $331.13 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $239.88 Median $354.81 Typical High $467.74 | Professional | None | $239.88 | $354.81 | $467.74 |
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 $151.36 Median $239.88 Typical High $398.11 | Professional | None | $151.36 | $239.88 | $398.11 |
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 $109.65 Median $131.83 Typical High $169.82 | Professional | 52 · Reduced service | $109.65 | $131.83 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $52.48 Typical High $67.61 | Professional | 53 · Discontinued | $44.67 | $52.48 | $67.61 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $154.88 Median $186.21 Typical High $234.42 | Professional | 78 · Unplanned return to OR | $154.88 | $186.21 | $234.42 |
Where Rhode Island sits
The same service costs 4.3 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
$288
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.