How much rates vary
Facilitymedian $1,413 · 10th to 90th $676 to $4,898Professionalmedian $1,000 · 10th to 90th $661 to $1,318
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 $1,513.56 Median $1,548.82 Typical High $3,981.07 | Facility | None | $1,513.56 | $1,548.82 | $3,981.07 |
Aetna Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,000.00 | Professional | None | $1,000.00 | $1,000.00 | $1,000.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $758.58 Typical High $758.58 | Professional | 54 · Surgery only | $758.58 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | 55 · Aftercare only | $151.36 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | 56 · Pre-op care only | $100.00 | $100.00 | $100.00 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $660.69 Median $870.96 Typical High $1,288.25 | Professional | None | $660.69 | $870.96 | $1,288.25 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $512.86 Typical High $602.56 | Professional | 54 · Surgery only | $416.87 | $512.86 | $602.56 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $154.88 Typical High $181.97 | Professional | 55 · Aftercare only | $128.82 | $154.88 | $181.97 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $74.13 Typical High $87.10 | Professional | 56 · Pre-op care only | $61.66 | $74.13 | $87.10 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $1,202.26 Typical High $1,621.81 | Facility | None | $676.08 | $1,202.26 | $1,621.81 |
Cigna Setting Professional Modifier None Typical Low $1,071.52 Median $1,318.26 Typical High $1,513.56 | Professional | None | $1,071.52 | $1,318.26 | $1,513.56 |
United Setting Facility Modifier None Typical Low $645.65 Median $1,445.44 Typical High $5,011.87 | Facility | None | $645.65 | $1,445.44 | $5,011.87 |
United Setting Professional Modifier None Typical Low $616.60 Median $870.96 Typical High $1,412.54 | Professional | None | $616.60 | $870.96 | $1,412.54 |
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 $501.19 Median $501.19 Typical High $501.19 | Professional | 52 · Reduced service | $501.19 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $199.53 Typical High $199.53 | Professional | 53 · Discontinued | $199.53 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $707.95 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $707.95 | $707.95 | $707.95 |
Where Rhode Island sits
The same service costs 4.3 times more in Alaska than in Alabama. 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 $6,582AL $1,537
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.