How much rates vary
Facilitymedian $3,236 · 10th to 90th $832 to $7,762Professionalmedian $1,288 · 10th to 90th $912 to $1,862
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 $1,288.25 Median $1,288.25 Typical High $1,348.96 | Professional | None | $1,288.25 | $1,288.25 | $1,348.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $954.99 Typical High $954.99 | Professional | 54 · Surgery only | $954.99 | $954.99 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $190.55 Typical High $190.55 | Professional | 55 · Aftercare only | $190.55 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $128.82 Typical High $128.82 | Professional | 56 · Pre-op care only | $128.82 | $128.82 | $128.82 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $933.25 Median $1,258.93 Typical High $1,737.80 | Professional | None | $933.25 | $1,258.93 | $1,737.80 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $741.31 Typical High $870.96 | Professional | 54 · Surgery only | $602.56 | $741.31 | $870.96 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $223.87 Typical High $263.03 | Professional | 55 · Aftercare only | $186.21 | $223.87 | $263.03 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $107.15 Typical High $125.89 | Professional | 56 · Pre-op care only | $89.13 | $107.15 | $125.89 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $4,786.30 Typical High $6,918.31 | Facility | None | $831.76 | $4,786.30 | $6,918.31 |
Cigna Setting Professional Modifier None Typical Low $1,445.44 Median $1,862.09 Typical High $2,041.74 | Professional | None | $1,445.44 | $1,862.09 | $2,041.74 |
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 $831.76 Median $1,071.52 Typical High $1,862.09 | Professional | None | $831.76 | $1,071.52 | $1,862.09 |
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 $630.96 Median $630.96 Typical High $630.96 | Professional | 52 · Reduced service | $630.96 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $257.04 Typical High $257.04 | Professional | 53 · Discontinued | $257.04 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $891.25 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $891.25 | $891.25 | $891.25 |
Where Rhode Island sits
The same service costs 3.9 times more in Alaska than in Delaware. 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 $12,209DE $3,093
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.