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 $3,467.37 Median $3,715.35 Typical High $3,981.07 | Facility | None | $3,467.37 | $3,715.35 | $3,981.07 |
Aetna Setting Professional Modifier None Typical Low $524.81 Median $758.58 Typical High $776.25 | Professional | None | $524.81 | $758.58 | $776.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $562.34 Typical High $588.84 | Professional | 54 · Surgery only | $389.05 | $562.34 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $114.82 Typical High $117.49 | Professional | 55 · Aftercare only | $77.62 | $114.82 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $75.86 Typical High $77.62 | Professional | 56 · Pre-op care only | $52.48 | $75.86 | $77.62 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $501.19 Median $602.56 Typical High $891.25 | Professional | None | $501.19 | $602.56 | $891.25 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $416.87 Typical High $537.03 | Professional | 54 · Surgery only | $288.40 | $416.87 | $537.03 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $117.49 Typical High $151.36 | Professional | 55 · Aftercare only | $83.18 | $117.49 | $151.36 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $58.88 Typical High $75.86 | Professional | 56 · Pre-op care only | $41.69 | $58.88 | $75.86 |
Cigna Setting Facility Modifier None Typical Low $354.81 Median $478.63 Typical High $794.33 | Facility | None | $354.81 | $478.63 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $588.84 Median $891.25 Typical High $933.25 | Professional | None | $588.84 | $891.25 | $933.25 |
United Setting Facility Modifier None Typical Low $371.54 Median $1,096.48 Typical High $4,265.80 | Facility | None | $371.54 | $1,096.48 | $4,265.80 |
United Setting Professional Modifier None Typical Low $478.63 Median $602.56 Typical High $870.96 | Professional | None | $478.63 | $602.56 | $870.96 |
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 $263.03 Median $380.19 Typical High $389.05 | Professional | 52 · Reduced service | $263.03 | $380.19 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $151.36 Typical High $154.88 | Professional | 53 · Discontinued | $104.71 | $151.36 | $154.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $524.81 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $363.08 | $524.81 | $549.54 |
Where Rhode Island sits
The same service costs 6.2 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· 22nd of 51
$708
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.