How much rates vary
Facilitymedian $2,754 · 10th to 90th $871 to $9,550Professionalmedian $2,089 · 10th to 90th $1,413 to $2,818
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 $2,089.30 Median $2,089.30 Typical High $2,089.30 | Professional | None | $2,089.30 | $2,089.30 | $2,089.30 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,584.89 Median $1,584.89 Typical High $1,584.89 | Professional | 54 · Surgery only | $1,584.89 | $1,584.89 | $1,584.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $316.23 Median $316.23 Typical High $316.23 | Professional | 55 · Aftercare only | $316.23 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $208.93 Median $208.93 Typical High $208.93 | Professional | 56 · Pre-op care only | $208.93 | $208.93 | $208.93 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $1,412.54 Median $1,905.46 Typical High $2,754.23 | Professional | None | $1,412.54 | $1,905.46 | $2,754.23 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $1,122.02 Typical High $1,318.26 | Professional | 54 · Surgery only | $912.01 | $1,122.02 | $1,318.26 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $275.42 Median $338.84 Typical High $398.11 | Professional | 55 · Aftercare only | $275.42 | $338.84 | $398.11 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $162.18 Typical High $190.55 | Professional | 56 · Pre-op care only | $131.83 | $162.18 | $190.55 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $8,912.51 Typical High $12,589.25 | Facility | None | $676.08 | $8,912.51 | $12,589.25 |
Cigna Setting Professional Modifier None Typical Low $2,187.76 Median $2,818.38 Typical High $3,311.31 | Professional | None | $2,187.76 | $2,818.38 | $3,311.31 |
United Setting Facility Modifier None Typical Low $870.96 Median $2,089.30 Typical High $7,413.10 | Facility | None | $870.96 | $2,089.30 | $7,413.10 |
United Setting Professional Modifier None Typical Low $1,318.26 Median $1,778.28 Typical High $2,951.21 | Professional | None | $1,318.26 | $1,778.28 | $2,951.21 |
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 $1,047.13 Median $1,047.13 Typical High $1,047.13 | Professional | 52 · Reduced service | $1,047.13 | $1,047.13 | $1,047.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $416.87 Median $416.87 Typical High $416.87 | Professional | 53 · Discontinued | $416.87 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,479.11 Median $1,479.11 Typical High $1,479.11 | Professional | 78 · Unplanned return to OR | $1,479.11 | $1,479.11 | $1,479.11 |
Where Rhode Island sits
The same service costs 6.3 times more in Alaska than in Texas. 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 $16,928TX $2,675
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.