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 $537.03 Median $575.44 Typical High $575.44 | Professional | None | $537.03 | $575.44 | $575.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $436.52 Typical High $436.52 | Professional | 54 · Surgery only | $407.38 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $87.10 Typical High $87.10 | Professional | 55 · Aftercare only | $81.28 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $57.54 Typical High $57.54 | Professional | 56 · Pre-op care only | $53.70 | $57.54 | $57.54 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $562.34 Median $660.69 Typical High $891.25 | Professional | None | $562.34 | $660.69 | $891.25 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $457.09 Typical High $549.54 | Professional | 54 · Surgery only | $323.59 | $457.09 | $549.54 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $131.83 Typical High $158.49 | Professional | 55 · Aftercare only | $93.33 | $131.83 | $158.49 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $66.07 Typical High $79.43 | Professional | 56 · Pre-op care only | $45.71 | $66.07 | $79.43 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $1,621.81 Typical High $2,344.23 | Facility | None | $446.68 | $1,621.81 | $2,344.23 |
Cigna Setting Professional Modifier None Typical Low $549.54 Median $1,023.29 Typical High $1,023.29 | Professional | None | $549.54 | $1,023.29 | $1,023.29 |
United Setting Facility Modifier None Typical Low $870.96 Median $2,089.30 Typical High $5,888.44 | Facility | None | $870.96 | $2,089.30 | $5,888.44 |
United Setting Professional Modifier None Typical Low $436.52 Median $489.78 Typical High $831.76 | Professional | None | $436.52 | $489.78 | $831.76 |
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 $269.15 Median $288.40 Typical High $288.40 | Professional | 52 · Reduced service | $269.15 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $114.82 Typical High $114.82 | Professional | 53 · Discontinued | $107.15 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $407.38 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $380.19 | $407.38 | $407.38 |
Where Rhode Island sits
The same service costs 8.3 times more in Wyoming than in Texas. 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· 32nd of 51
$661
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.