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 $213.80 Median $239.88 Typical High $295.12 | Professional | None | $213.80 | $239.88 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $169.82 Typical High $223.87 | Professional | 54 · Surgery only | $158.49 | $169.82 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $33.88 Typical High $44.67 | Professional | 55 · Aftercare only | $31.62 | $33.88 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $22.91 Typical High $29.51 | Professional | 56 · Pre-op care only | $21.38 | $22.91 | $29.51 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $190.55 Median $269.15 Typical High $316.23 | Professional | None | $190.55 | $269.15 | $316.23 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $177.83 Typical High $251.19 | Professional | 54 · Surgery only | $125.89 | $177.83 | $251.19 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $22.39 Typical High $31.62 | Professional | 55 · Aftercare only | $15.85 | $22.39 | $31.62 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $22.39 Typical High $31.62 | Professional | 56 · Pre-op care only | $15.85 | $22.39 | $31.62 |
Cigna Setting Facility Modifier None Typical Low $186.21 Median $251.19 Typical High $1,202.26 | Facility | None | $186.21 | $251.19 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $309.03 Typical High $389.05 | Professional | None | $275.42 | $309.03 | $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 $154.88 Median $218.78 Typical High $295.12 | Professional | None | $154.88 | $218.78 | $295.12 |
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 $107.15 Median $114.82 Typical High $147.91 | Professional | 52 · Reduced service | $107.15 | $114.82 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $45.71 Typical High $58.88 | Professional | 53 · Discontinued | $42.66 | $45.71 | $58.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $147.91 Median $158.49 Typical High $208.93 | Professional | 78 · Unplanned return to OR | $147.91 | $158.49 | $208.93 |
Where Rhode Island sits
The same service costs 3.8 times more in Alaska than in New Jersey. 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· 24th of 51
$269
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.