How much rates vary
Facilitymedian $4,786 · 10th to 90th $1,023 to $13,804Professionalmedian $1,479 · 10th to 90th $1,023 to $2,042
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 $3,715.35 Median $3,981.07 Typical High $4,897.79 | Facility | None | $3,715.35 | $3,981.07 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,513.56 | Professional | None | $1,479.11 | $1,479.11 | $1,513.56 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,122.02 Typical High $1,122.02 | Professional | 54 · Surgery only | $1,122.02 | $1,122.02 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $223.87 Typical High $223.87 | Professional | 55 · Aftercare only | $223.87 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $147.91 Typical High $147.91 | Professional | 56 · Pre-op care only | $147.91 | $147.91 | $147.91 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $1,023.29 Median $1,348.96 Typical High $1,949.84 | Professional | None | $1,023.29 | $1,348.96 | $1,949.84 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $794.33 Typical High $933.25 | Professional | 54 · Surgery only | $660.69 | $794.33 | $933.25 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $239.88 Typical High $281.84 | Professional | 55 · Aftercare only | $199.53 | $239.88 | $281.84 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $114.82 Typical High $134.90 | Professional | 56 · Pre-op care only | $95.50 | $114.82 | $134.90 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $11,220.18 Typical High $16,218.10 | Facility | None | $676.08 | $11,220.18 | $16,218.10 |
Cigna Setting Professional Modifier None Typical Low $1,548.82 Median $1,995.26 Typical High $2,344.23 | Professional | None | $1,548.82 | $1,995.26 | $2,344.23 |
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 $933.25 Median $1,230.27 Typical High $2,137.96 | Professional | None | $933.25 | $1,230.27 | $2,137.96 |
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 $741.31 Median $741.31 Typical High $741.31 | Professional | 52 · Reduced service | $741.31 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $295.12 Typical High $295.12 | Professional | 53 · Discontinued | $295.12 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,047.13 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,047.13 | $1,047.13 |
Where Rhode Island sits
The same service costs 10.4 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 $29,118KY $2,808
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.