How much rates vary
Facilitymedian $3,802 · 10th to 90th $933 to $10,233Professionalmedian $2,188 · 10th to 90th $1,479 to $2,951
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 $2,187.76 Median $2,187.76 Typical High $2,187.76 | Professional | None | $2,187.76 | $2,187.76 | $2,187.76 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,659.59 Median $1,659.59 Typical High $1,659.59 | Professional | 54 · Surgery only | $1,659.59 | $1,659.59 | $1,659.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $331.13 Median $331.13 Typical High $331.13 | Professional | 55 · Aftercare only | $331.13 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $218.78 Median $218.78 Typical High $218.78 | Professional | 56 · Pre-op care only | $218.78 | $218.78 | $218.78 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $1,479.11 Median $1,949.84 Typical High $2,884.03 | Professional | None | $1,479.11 | $1,949.84 | $2,884.03 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $1,148.15 Typical High $1,348.96 | Professional | 54 · Surgery only | $954.99 | $1,148.15 | $1,348.96 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $288.40 Median $346.74 Typical High $416.87 | Professional | 55 · Aftercare only | $288.40 | $346.74 | $416.87 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $165.96 Typical High $194.98 | Professional | 56 · Pre-op care only | $138.04 | $165.96 | $194.98 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $6,309.57 Typical High $9,120.11 | Facility | None | $676.08 | $6,309.57 | $9,120.11 |
Cigna Setting Professional Modifier None Typical Low $2,344.23 Median $2,951.21 Typical High $3,388.44 | Professional | None | $2,344.23 | $2,951.21 | $3,388.44 |
United Setting Facility Modifier None Typical Low $933.25 Median $3,548.13 Typical High $12,589.25 | Facility | None | $933.25 | $3,548.13 | $12,589.25 |
United Setting Professional Modifier None Typical Low $1,348.96 Median $1,862.09 Typical High $3,090.30 | Professional | None | $1,348.96 | $1,862.09 | $3,090.30 |
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 $1,096.48 Median $1,096.48 Typical High $1,096.48 | Professional | 52 · Reduced service | $1,096.48 | $1,096.48 | $1,096.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $436.52 Median $436.52 Typical High $436.52 | Professional | 53 · Discontinued | $436.52 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,548.82 Median $1,548.82 Typical High $1,548.82 | Professional | 78 · Unplanned return to OR | $1,548.82 | $1,548.82 | $1,548.82 |
Where Rhode Island sits
The same service costs 4.7 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 $16,761KY $3,604
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.