How much rates vary
Facilitymedian $3,715 · 10th to 90th $1,023 to $10,000Professionalmedian $741 · 10th to 90th $501 to $1,023
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 $707.95 Median $741.31 Typical High $870.96 | Professional | None | $707.95 | $741.31 | $870.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $549.54 Typical High $549.54 | Professional | 54 · Surgery only | $549.54 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | 55 · Aftercare only | $109.65 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $74.13 Typical High $74.13 | Professional | 56 · Pre-op care only | $74.13 | $74.13 | $74.13 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $524.81 Median $707.95 Typical High $977.24 | Professional | None | $524.81 | $707.95 | $977.24 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $416.87 Typical High $489.78 | Professional | 54 · Surgery only | $338.84 | $416.87 | $489.78 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $125.89 Typical High $147.91 | Professional | 55 · Aftercare only | $104.71 | $125.89 | $147.91 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $60.26 Typical High $70.79 | Professional | 56 · Pre-op care only | $48.98 | $60.26 | $70.79 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $2,137.96 Typical High $3,090.30 | Facility | None | $831.76 | $2,137.96 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $794.33 Median $1,023.29 Typical High $1,174.90 | Professional | None | $794.33 | $1,023.29 | $1,174.90 |
United Setting Facility Modifier None Typical Low $1,023.29 Median $4,570.88 Typical High $10,471.29 | Facility | None | $1,023.29 | $4,570.88 | $10,471.29 |
United Setting Professional Modifier None Typical Low $457.09 Median $549.54 Typical High $1,071.52 | Professional | None | $457.09 | $549.54 | $1,071.52 |
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 $363.08 Median $363.08 Typical High $363.08 | Professional | 52 · Reduced service | $363.08 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $147.91 Typical High $147.91 | Professional | 53 · Discontinued | $147.91 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $512.86 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $512.86 | $512.86 | $512.86 |
Where Rhode Island sits
The same service costs 4.7 times more in Oklahoma 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
OK $8,820MT $1,888
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.