How much rates vary
Facilitymedian $2,630 · 10th to 90th $813 to $7,244Professionalmedian $977 · 10th to 90th $708 to $1,445
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 $2,398.83 Median $3,235.94 Typical High $3,981.07 | Facility | None | $2,398.83 | $3,235.94 | $3,981.07 |
Aetna Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $977.24 | Professional | None | $977.24 | $977.24 | $977.24 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $724.44 Typical High $724.44 | Professional | 54 · Surgery only | $724.44 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $147.91 Typical High $147.91 | Professional | 55 · Aftercare only | $147.91 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $97.72 Typical High $97.72 | Professional | 56 · Pre-op care only | $97.72 | $97.72 | $97.72 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $724.44 Median $954.99 Typical High $1,318.26 | Professional | None | $724.44 | $954.99 | $1,318.26 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $562.34 Typical High $660.69 | Professional | 54 · Surgery only | $457.09 | $562.34 | $660.69 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $169.82 Typical High $199.53 | Professional | 55 · Aftercare only | $141.25 | $169.82 | $199.53 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $81.28 Typical High $95.50 | Professional | 56 · Pre-op care only | $67.61 | $81.28 | $95.50 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $2,137.96 Typical High $3,090.30 | Facility | None | $676.08 | $2,137.96 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $1,230.27 Median $1,445.44 Typical High $1,513.56 | Professional | None | $1,230.27 | $1,445.44 | $1,513.56 |
United Setting Facility Modifier None Typical Low $812.83 Median $2,630.27 Typical High $7,762.47 | Facility | None | $812.83 | $2,630.27 | $7,762.47 |
United Setting Professional Modifier None Typical Low $630.96 Median $891.25 Typical High $1,445.44 | Professional | None | $630.96 | $891.25 | $1,445.44 |
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 $489.78 Median $489.78 Typical High $489.78 | Professional | 52 · Reduced service | $489.78 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $194.98 Typical High $194.98 | Professional | 53 · Discontinued | $194.98 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $676.08 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $676.08 | $676.08 | $676.08 |
Where Rhode Island sits
The same service costs 3.1 times more in Wisconsin than in Hawaii. 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
WI $7,619HI $2,493
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.