How much rates vary
Facilitymedian $5,623 · 10th to 90th $1,202 to $19,498Professionalmedian $2,344 · 10th to 90th $1,585 to $3,162
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 $2,344.23 Median $2,344.23 Typical High $2,344.23 | Professional | None | $2,344.23 | $2,344.23 | $2,344.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,778.28 Median $1,778.28 Typical High $1,778.28 | Professional | 54 · Surgery only | $1,778.28 | $1,778.28 | $1,778.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $354.81 Median $354.81 Typical High $354.81 | Professional | 55 · Aftercare only | $354.81 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $234.42 Median $234.42 Typical High $234.42 | Professional | 56 · Pre-op care only | $234.42 | $234.42 | $234.42 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $1,584.89 Median $2,089.30 Typical High $3,090.30 | Professional | None | $1,584.89 | $2,089.30 | $3,090.30 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,230.27 Typical High $1,445.44 | Professional | 54 · Surgery only | $1,023.29 | $1,230.27 | $1,445.44 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $309.03 Median $371.54 Typical High $436.52 | Professional | 55 · Aftercare only | $309.03 | $371.54 | $436.52 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $177.83 Typical High $208.93 | Professional | 56 · Pre-op care only | $147.91 | $177.83 | $208.93 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $15,488.17 Typical High $22,387.21 | Facility | None | $676.08 | $15,488.17 | $22,387.21 |
Cigna Setting Professional Modifier None Typical Low $2,884.03 Median $3,162.28 Typical High $3,630.78 | Professional | None | $2,884.03 | $3,162.28 | $3,630.78 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $5,623.41 Typical High $19,054.61 | Facility | None | $1,230.27 | $5,623.41 | $19,054.61 |
United Setting Professional Modifier None Typical Low $1,479.11 Median $2,238.72 Typical High $3,311.31 | Professional | None | $1,479.11 | $2,238.72 | $3,311.31 |
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 $1,174.90 Median $1,174.90 Typical High $1,174.90 | Professional | 52 · Reduced service | $1,174.90 | $1,174.90 | $1,174.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $467.74 Median $467.74 Typical High $467.74 | Professional | 53 · Discontinued | $467.74 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,659.59 Median $1,659.59 Typical High $1,659.59 | Professional | 78 · Unplanned return to OR | $1,659.59 | $1,659.59 | $1,659.59 |
Where Rhode Island sits
The same service costs 7.8 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 $31,233KY $3,989
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.