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 $3,981.07 Typical High $4,897.79 | Facility | None | $3,715.35 | $3,981.07 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $562.34 | Professional | None | $562.34 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $416.87 Typical High $416.87 | Professional | 54 · Surgery only | $416.87 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | 55 · Aftercare only | $83.18 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $56.23 Typical High $56.23 | Professional | 56 · Pre-op care only | $56.23 | $56.23 | $56.23 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $398.11 Median $537.03 Typical High $870.96 | Professional | None | $398.11 | $537.03 | $870.96 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $363.08 Typical High $602.56 | Professional | 54 · Surgery only | $257.04 | $363.08 | $602.56 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $45.71 Typical High $74.13 | Professional | 55 · Aftercare only | $31.62 | $45.71 | $74.13 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $45.71 Typical High $74.13 | Professional | 56 · Pre-op care only | $31.62 | $45.71 | $74.13 |
Cigna Setting Facility Modifier None Typical Low $1,778.28 Median $3,981.07 Typical High $5,623.41 | Facility | None | $1,778.28 | $3,981.07 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $549.54 Median $812.83 Typical High $912.01 | Professional | None | $549.54 | $812.83 | $912.01 |
United Setting Facility Modifier None Typical Low $1,023.29 Median $4,570.88 Typical High $12,882.50 | Facility | None | $1,023.29 | $4,570.88 | $12,882.50 |
United Setting Professional Modifier None Typical Low $389.05 Median $501.19 Typical High $758.58 | Professional | None | $389.05 | $501.19 | $758.58 |
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 $281.84 Median $281.84 Typical High $281.84 | Professional | 52 · Reduced service | $281.84 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $112.20 Typical High $112.20 | Professional | 53 · Discontinued | $112.20 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $389.05 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $389.05 | $389.05 | $389.05 |
Where Rhode Island sits
The same service costs 9.5 times more in Oklahoma 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· 40th of 51
$562
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.