How much rates vary
Facilitymedian $3,236 · 10th to 90th $832 to $8,710Professionalmedian $1,072 · 10th to 90th $776 to $1,585
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 $1,071.52 Median $1,071.52 Typical High $1,071.52 | Professional | None | $1,071.52 | $1,071.52 | $1,071.52 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $812.83 Typical High $812.83 | Professional | 54 · Surgery only | $812.83 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | 55 · Aftercare only | $162.18 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $107.15 Typical High $107.15 | Professional | 56 · Pre-op care only | $107.15 | $107.15 | $107.15 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $794.33 Median $1,047.13 Typical High $1,445.44 | Professional | None | $794.33 | $1,047.13 | $1,445.44 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $616.60 Typical High $724.44 | Professional | 54 · Surgery only | $512.86 | $616.60 | $724.44 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $186.21 Typical High $218.78 | Professional | 55 · Aftercare only | $154.88 | $186.21 | $218.78 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $89.13 Typical High $104.71 | Professional | 56 · Pre-op care only | $74.13 | $89.13 | $104.71 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $6,165.95 Typical High $8,709.64 | Facility | None | $831.76 | $6,165.95 | $8,709.64 |
Cigna Setting Professional Modifier None Typical Low $1,348.96 Median $1,584.89 Typical High $1,698.24 | Professional | None | $1,348.96 | $1,584.89 | $1,698.24 |
United Setting Facility Modifier None Typical Low $812.83 Median $2,630.27 Typical High $9,549.93 | Facility | None | $812.83 | $2,630.27 | $9,549.93 |
United Setting Professional Modifier None Typical Low $691.83 Median $954.99 Typical High $1,584.89 | Professional | None | $691.83 | $954.99 | $1,584.89 |
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 $537.03 Median $537.03 Typical High $537.03 | Professional | 52 · Reduced service | $537.03 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $213.80 Typical High $213.80 | Professional | 53 · Discontinued | $213.80 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $758.58 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $758.58 | $758.58 | $758.58 |
Where Rhode Island sits
The same service costs 4.5 times more in Alaska than in Montana. 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 $12,963MT $2,892
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.