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 $223.87 Median $288.40 Typical High $323.59 | Professional | None | $223.87 | $288.40 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $169.82 Typical High $213.80 | Professional | 54 · Surgery only | $165.96 | $169.82 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $33.88 Typical High $42.66 | Professional | 55 · Aftercare only | $33.11 | $33.88 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $22.91 Typical High $28.84 | Professional | 56 · Pre-op care only | $22.39 | $22.91 | $28.84 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $186.21 Median $239.88 Typical High $380.19 | Professional | None | $186.21 | $239.88 | $380.19 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $173.78 Typical High $288.40 | Professional | 54 · Surgery only | $123.03 | $173.78 | $288.40 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $21.88 Typical High $35.48 | Professional | 55 · Aftercare only | $15.14 | $21.88 | $35.48 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $21.88 Typical High $35.48 | Professional | 56 · Pre-op care only | $15.14 | $21.88 | $35.48 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $1,479.11 Typical High $2,089.30 | Facility | None | $446.68 | $1,479.11 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $251.19 Median $323.59 Typical High $416.87 | Professional | None | $251.19 | $323.59 | $416.87 |
United Setting Facility Modifier None Typical Low $645.65 Median $1,445.44 Typical High $5,011.87 | Facility | None | $645.65 | $1,445.44 | $5,011.87 |
United Setting Professional Modifier None Typical Low $165.96 Median $234.42 Typical High $371.54 | Professional | None | $165.96 | $234.42 | $371.54 |
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 $112.20 Median $112.20 Typical High $144.54 | Professional | 52 · Reduced service | $112.20 | $112.20 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $45.71 Typical High $57.54 | Professional | 53 · Discontinued | $44.67 | $45.71 | $57.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $154.88 Median $158.49 Typical High $199.53 | Professional | 78 · Unplanned return to OR | $154.88 | $158.49 | $199.53 |
Where Rhode Island sits
The same service costs 4.6 times more in Alaska than in Utah. 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
$282
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.