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 $5,495.41 | Facility | None | $3,715.35 | $3,981.07 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $1,230.27 Median $1,380.38 Typical High $1,380.38 | Professional | None | $1,230.27 | $1,380.38 | $1,380.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $1,047.13 Typical High $1,047.13 | Professional | 54 · Surgery only | $912.01 | $1,047.13 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $208.93 Typical High $208.93 | Professional | 55 · Aftercare only | $186.21 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $138.04 Typical High $138.04 | Professional | 56 · Pre-op care only | $123.03 | $138.04 | $138.04 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $1,258.93 Median $1,479.11 Typical High $2,137.96 | Professional | None | $1,258.93 | $1,479.11 | $2,137.96 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $1,023.29 Typical High $1,318.26 | Professional | 54 · Surgery only | $724.44 | $1,023.29 | $1,318.26 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $295.12 Typical High $371.54 | Professional | 55 · Aftercare only | $208.93 | $295.12 | $371.54 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $147.91 Typical High $186.21 | Professional | 56 · Pre-op care only | $102.33 | $147.91 | $186.21 |
United Setting Facility Modifier None Typical Low $933.25 Median $3,548.13 Typical High $10,232.93 | Facility | None | $933.25 | $3,548.13 | $10,232.93 |
United Setting Professional Modifier None Typical Low $1,023.29 Median $1,174.90 Typical High $1,905.46 | Professional | None | $1,023.29 | $1,174.90 | $1,905.46 |
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 $616.60 Median $691.83 Typical High $691.83 | Professional | 52 · Reduced service | $616.60 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $275.42 Typical High $275.42 | Professional | 53 · Discontinued | $245.47 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $977.24 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $851.14 | $977.24 | $977.24 |
Where Rhode Island sits
The same service costs 7.8 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· 38th of 51
$1,380
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.