How much rates vary
Facilitymedian $2,630 · 10th to 90th $871 to $5,888Professionalmedian $631 · 10th to 90th $437 to $912
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 $630.96 Median $630.96 Typical High $676.08 | Professional | None | $630.96 | $630.96 | $676.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $478.63 Typical High $478.63 | Professional | 54 · Surgery only | $478.63 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $95.50 Typical High $95.50 | Professional | 55 · Aftercare only | $95.50 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | 56 · Pre-op care only | $63.10 | $63.10 | $63.10 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $467.74 Median $616.60 Typical High $851.14 | Professional | None | $467.74 | $616.60 | $851.14 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $363.08 Typical High $426.58 | Professional | 54 · Surgery only | $302.00 | $363.08 | $426.58 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $109.65 Typical High $128.82 | Professional | 55 · Aftercare only | $91.20 | $109.65 | $128.82 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $52.48 Typical High $61.66 | Professional | 56 · Pre-op care only | $43.65 | $52.48 | $61.66 |
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 $691.83 Median $912.01 Typical High $1,023.29 | Professional | None | $691.83 | $912.01 | $1,023.29 |
United Setting Facility Modifier None Typical Low $870.96 Median $2,089.30 Typical High $7,244.36 | Facility | None | $870.96 | $2,089.30 | $7,244.36 |
United Setting Professional Modifier None Typical Low $371.54 Median $467.74 Typical High $933.25 | Professional | None | $371.54 | $467.74 | $933.25 |
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 $316.23 Median $316.23 Typical High $316.23 | Professional | 52 · Reduced service | $316.23 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | 53 · Discontinued | $125.89 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $446.68 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $446.68 | $446.68 | $446.68 |
Where Rhode Island sits
The same service costs 5.0 times more in Alabama 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
AL $8,351MT $1,664
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.