How much rates vary
Facilitymedian $4,467 · 10th to 90th $1,023 to $10,471Professionalmedian $2,512 · 10th to 90th $1,445 to $3,631
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 $3,467.37 Median $3,715.35 Typical High $3,981.07 | Facility | None | $3,467.37 | $3,715.35 | $3,981.07 |
Aetna Setting Professional Modifier None Typical Low $2,511.89 Median $2,511.89 Typical High $2,511.89 | Professional | None | $2,511.89 | $2,511.89 | $2,511.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,905.46 Median $1,905.46 Typical High $1,905.46 | Professional | 54 · Surgery only | $1,905.46 | $1,905.46 | $1,905.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $380.19 Median $380.19 Typical High $380.19 | Professional | 55 · Aftercare only | $380.19 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $251.19 Median $251.19 Typical High $251.19 | Professional | 56 · Pre-op care only | $251.19 | $251.19 | $251.19 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $1,819.70 Median $2,454.71 Typical High $3,548.13 | Professional | None | $1,819.70 | $2,454.71 | $3,548.13 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $1,174.90 Median $1,412.54 Typical High $1,698.24 | Professional | 54 · Surgery only | $1,174.90 | $1,412.54 | $1,698.24 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $354.81 Median $436.52 Typical High $512.86 | Professional | 55 · Aftercare only | $354.81 | $436.52 | $512.86 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $169.82 Median $208.93 Typical High $245.47 | Professional | 56 · Pre-op care only | $169.82 | $208.93 | $245.47 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $4,786.30 Typical High $6,918.31 | Facility | None | $676.08 | $4,786.30 | $6,918.31 |
Cigna Setting Professional Modifier None Typical Low $2,691.53 Median $3,630.78 Typical High $4,168.69 | Professional | None | $2,691.53 | $3,630.78 | $4,168.69 |
United Setting Facility Modifier None Typical Low $1,023.29 Median $4,570.88 Typical High $12,882.50 | Facility | None | $1,023.29 | $4,570.88 | $12,882.50 |
United Setting Professional Modifier None Typical Low $1,023.29 Median $1,778.28 Typical High $3,715.35 | Professional | None | $1,023.29 | $1,778.28 | $3,715.35 |
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 $1,258.93 Median $1,258.93 Typical High $1,258.93 | Professional | 52 · Reduced service | $1,258.93 | $1,258.93 | $1,258.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $501.19 Median $501.19 Typical High $501.19 | Professional | 53 · Discontinued | $501.19 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,778.28 Median $1,778.28 Typical High $1,778.28 | Professional | 78 · Unplanned return to OR | $1,778.28 | $1,778.28 | $1,778.28 |
Where Rhode Island sits
The same service costs 4.9 times more in Alaska than in Kentucky. 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 $18,090KY $3,723
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.