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 $141.25 Median $173.78 Typical High $208.93 | Professional | None | $141.25 | $173.78 | $208.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $131.83 Typical High $131.83 | Professional | 54 · Surgery only | $117.49 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $26.30 Typical High $26.30 | Professional | 55 · Aftercare only | $23.44 | $26.30 | $26.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $17.38 Typical High $17.38 | Professional | 56 · Pre-op care only | $15.85 | $17.38 | $17.38 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $128.82 Median $158.49 Typical High $269.15 | Professional | None | $128.82 | $158.49 | $269.15 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $112.20 Typical High $151.36 | Professional | 54 · Surgery only | $83.18 | $112.20 | $151.36 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $14.13 Typical High $18.62 | Professional | 55 · Aftercare only | $10.47 | $14.13 | $18.62 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $14.13 Typical High $18.62 | Professional | 56 · Pre-op care only | $10.47 | $14.13 | $18.62 |
Cigna Setting Facility Modifier None Typical Low $91.20 Median $125.89 Typical High $1,202.26 | Facility | None | $91.20 | $125.89 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $208.93 Median $251.19 Typical High $263.03 | Professional | None | $208.93 | $251.19 | $263.03 |
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 $107.15 Median $165.96 Typical High $269.15 | Professional | None | $107.15 | $165.96 | $269.15 |
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 $79.43 Median $87.10 Typical High $87.10 | Professional | 52 · Reduced service | $79.43 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $34.67 Typical High $34.67 | Professional | 53 · Discontinued | $31.62 | $34.67 | $34.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $109.65 Median $123.03 Typical High $123.03 | Professional | 78 · Unplanned return to OR | $109.65 | $123.03 | $123.03 |
Where Rhode Island sits
The same service costs 3.9 times more in Alaska than in Florida. 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· 30th of 51
$174
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.