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 $281.84 Median $338.84 Typical High $416.87 | Professional | None | $281.84 | $338.84 | $416.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $257.04 Typical High $309.03 | Professional | 54 · Surgery only | $213.80 | $257.04 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $51.29 Typical High $61.66 | Professional | 55 · Aftercare only | $42.66 | $51.29 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $33.88 Typical High $41.69 | Professional | 56 · Pre-op care only | $28.18 | $33.88 | $41.69 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $234.42 Median $338.84 Typical High $602.56 | Professional | None | $234.42 | $338.84 | $602.56 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $223.87 Typical High $380.19 | Professional | 54 · Surgery only | $154.88 | $223.87 | $380.19 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $28.18 Typical High $46.77 | Professional | 55 · Aftercare only | $19.05 | $28.18 | $46.77 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $28.18 Typical High $46.77 | Professional | 56 · Pre-op care only | $19.05 | $28.18 | $46.77 |
Cigna Setting Facility Modifier None Typical Low $354.81 Median $478.63 Typical High $794.33 | Facility | None | $354.81 | $478.63 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $426.58 Typical High $524.81 | Professional | None | $331.13 | $426.58 | $524.81 |
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 $208.93 Median $323.59 Typical High $512.86 | Professional | None | $208.93 | $323.59 | $512.86 |
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 $141.25 Median $169.82 Typical High $208.93 | Professional | 52 · Reduced service | $141.25 | $169.82 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $67.61 Typical High $83.18 | Professional | 53 · Discontinued | $57.54 | $67.61 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $199.53 Median $239.88 Typical High $288.40 | Professional | 78 · Unplanned return to OR | $199.53 | $239.88 | $288.40 |
Where Rhode Island sits
The same service costs 3.7 times more in Wisconsin than in Texas. 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
$347
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.