How much rates vary
Facilitymedian $3,715 · 10th to 90th $933 to $10,233Professionalmedian $1,175 · 10th to 90th $776 to $1,549
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 $3,019.95 Median $3,715.35 Typical High $3,981.07 | Facility | None | $3,019.95 | $3,715.35 | $3,981.07 |
Aetna Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,174.90 | Professional | None | $1,174.90 | $1,174.90 | $1,174.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $870.96 Typical High $870.96 | Professional | 54 · Surgery only | $870.96 | $870.96 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | 55 · Aftercare only | $173.78 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $117.49 Typical High $117.49 | Professional | 56 · Pre-op care only | $117.49 | $117.49 | $117.49 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $776.25 Median $1,023.29 Typical High $1,513.56 | Professional | None | $776.25 | $1,023.29 | $1,513.56 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $602.56 Typical High $707.95 | Professional | 54 · Surgery only | $501.19 | $602.56 | $707.95 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $186.21 Typical High $218.78 | Professional | 55 · Aftercare only | $151.36 | $186.21 | $218.78 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $87.10 Typical High $102.33 | Professional | 56 · Pre-op care only | $72.44 | $87.10 | $102.33 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $3,981.07 Typical High $5,623.41 | Facility | None | $588.84 | $3,981.07 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $1,230.27 Median $1,548.82 Typical High $1,819.70 | Professional | None | $1,230.27 | $1,548.82 | $1,819.70 |
United Setting Facility Modifier None Typical Low $933.25 Median $3,548.13 Typical High $12,589.25 | Facility | None | $933.25 | $3,548.13 | $12,589.25 |
United Setting Professional Modifier None Typical Low $707.95 Median $977.24 Typical High $1,621.81 | Professional | None | $707.95 | $977.24 | $1,621.81 |
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 $575.44 Median $575.44 Typical High $575.44 | Professional | 52 · Reduced service | $575.44 | $575.44 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $234.42 Typical High $234.42 | Professional | 53 · Discontinued | $234.42 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $812.83 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $812.83 | $812.83 | $812.83 |
Where Rhode Island sits
The same service costs 3.9 times more in Alaska than in Kentucky. 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.
Physician feeFacility fee
AK $10,228KY $2,649
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.