How much rates vary
Facilitymedian $1,820 · 10th to 90th $676 to $5,012Professionalmedian $1,698 · 10th to 90th $1,096 to $2,399
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 $1,698.24 Median $1,698.24 Typical High $1,698.24 | Professional | None | $1,698.24 | $1,698.24 | $1,698.24 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,288.25 Median $1,288.25 Typical High $1,288.25 | Professional | 54 · Surgery only | $1,288.25 | $1,288.25 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $257.04 Typical High $257.04 | Professional | 55 · Aftercare only | $257.04 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $169.82 Median $169.82 Typical High $169.82 | Professional | 56 · Pre-op care only | $169.82 | $169.82 | $169.82 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $1,288.25 Median $1,698.24 Typical High $2,344.23 | Professional | None | $1,288.25 | $1,698.24 | $2,344.23 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $1,000.00 Typical High $1,174.90 | Professional | 54 · Surgery only | $812.83 | $1,000.00 | $1,174.90 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $251.19 Median $302.00 Typical High $354.81 | Professional | 55 · Aftercare only | $251.19 | $302.00 | $354.81 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $144.54 Typical High $169.82 | Professional | 56 · Pre-op care only | $120.23 | $144.54 | $169.82 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $1,621.81 Typical High $2,344.23 | Facility | None | $676.08 | $1,621.81 | $2,344.23 |
Cigna Setting Professional Modifier None Typical Low $1,862.09 Median $2,398.83 Typical High $2,754.23 | Professional | None | $1,862.09 | $2,398.83 | $2,754.23 |
United Setting Facility Modifier None Typical Low $645.65 Median $1,445.44 Typical High $5,754.40 | Facility | None | $645.65 | $1,445.44 | $5,754.40 |
United Setting Professional Modifier None Typical Low $977.24 Median $1,230.27 Typical High $2,511.89 | Professional | None | $977.24 | $1,230.27 | $2,511.89 |
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 $851.14 Median $851.14 Typical High $851.14 | Professional | 52 · Reduced service | $851.14 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $346.74 Median $346.74 Typical High $346.74 | Professional | 53 · Discontinued | $346.74 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,202.26 Median $1,202.26 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $1,202.26 | $1,202.26 | $1,202.26 |
Where Rhode Island sits
The same service costs 3.7 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 $8,917DE $2,410
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.