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 $169.82 Median $223.87 Typical High $269.15 | Professional | None | $169.82 | $223.87 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $147.91 Typical High $204.17 | Professional | 54 · Surgery only | $125.89 | $147.91 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $29.51 Typical High $40.74 | Professional | 55 · Aftercare only | $25.70 | $29.51 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $19.95 Typical High $26.92 | Professional | 56 · Pre-op care only | $16.98 | $19.95 | $26.92 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $147.91 Median $234.42 Typical High $309.03 | Professional | None | $147.91 | $234.42 | $309.03 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $144.54 Typical High $245.47 | Professional | 54 · Surgery only | $97.72 | $144.54 | $245.47 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $18.20 Typical High $30.90 | Professional | 55 · Aftercare only | $12.30 | $18.20 | $30.90 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $18.20 Typical High $30.90 | Professional | 56 · Pre-op care only | $12.30 | $18.20 | $30.90 |
Cigna Setting Facility Modifier None Typical Low $204.17 Median $275.42 Typical High $794.33 | Facility | None | $204.17 | $275.42 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $275.42 Typical High $389.05 | Professional | None | $213.80 | $275.42 | $389.05 |
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 $123.03 Median $186.21 Typical High $281.84 | Professional | None | $123.03 | $186.21 | $281.84 |
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 $85.11 Median $100.00 Typical High $134.90 | Professional | 52 · Reduced service | $85.11 | $100.00 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $39.81 Typical High $53.70 | Professional | 53 · Discontinued | $33.88 | $39.81 | $53.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $117.49 Median $138.04 Typical High $190.55 | Professional | 78 · Unplanned return to OR | $117.49 | $138.04 | $190.55 |
Where Rhode Island sits
The same service costs 3.3 times more in Alaska than in Washington, DC. 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
$214
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.