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 $3,715.35 Median $3,715.35 Typical High $3,981.07 | Facility | None | $3,715.35 | $3,715.35 | $3,981.07 |
Aetna Setting Professional Modifier None Typical Low $134.90 Median $169.82 Typical High $169.82 | Professional | None | $134.90 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $102.33 Median $104.71 Typical High $128.82 | Professional | 54 · Surgery only | $102.33 | $104.71 | $128.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $20.89 Typical High $25.70 | Professional | 55 · Aftercare only | $20.42 | $20.89 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $13.80 Typical High $16.98 | Professional | 56 · Pre-op care only | $13.49 | $13.80 | $16.98 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $114.82 Median $154.88 Typical High $229.09 | Professional | None | $114.82 | $154.88 | $229.09 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $107.15 Typical High $173.78 | Professional | 54 · Surgery only | $75.86 | $107.15 | $173.78 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $13.49 Typical High $21.38 | Professional | 55 · Aftercare only | $9.55 | $13.49 | $21.38 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $13.49 Typical High $21.38 | Professional | 56 · Pre-op care only | $9.55 | $13.49 | $21.38 |
Cigna Setting Facility Modifier None Typical Low $269.15 Median $269.15 Typical High $1,202.26 | Facility | None | $269.15 | $269.15 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $213.80 Typical High $269.15 | Professional | None | $158.49 | $213.80 | $269.15 |
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 $102.33 Median $138.04 Typical High $239.88 | Professional | None | $102.33 | $138.04 | $239.88 |
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 $67.61 Median $69.18 Typical High $85.11 | Professional | 52 · Reduced service | $67.61 | $69.18 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $27.54 Typical High $33.88 | Professional | 53 · Discontinued | $26.92 | $27.54 | $33.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $95.50 Median $97.72 Typical High $120.23 | Professional | 78 · Unplanned return to OR | $95.50 | $97.72 | $120.23 |
Where Rhode Island sits
The same service costs 4.2 times more in Alaska 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· 26th of 51
$170
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.