How much rates vary
Facilitymedian $3,236 · 10th to 90th $832 to $9,550Professionalmedian $832 · 10th to 90th $589 to $1,148
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 $3,019.95 Median $3,715.35 Typical High $3,981.07 | Facility | None | $3,019.95 | $3,715.35 | $3,981.07 |
Aetna Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $870.96 | Professional | None | $831.76 | $831.76 | $870.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $630.96 Typical High $630.96 | Professional | 54 · Surgery only | $630.96 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | 55 · Aftercare only | $125.89 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | 56 · Pre-op care only | $83.18 | $83.18 | $83.18 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $588.84 Median $776.25 Typical High $1,096.48 | Professional | None | $588.84 | $776.25 | $1,096.48 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $457.09 Typical High $537.03 | Professional | 54 · Surgery only | $380.19 | $457.09 | $537.03 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $141.25 Typical High $165.96 | Professional | 55 · Aftercare only | $114.82 | $141.25 | $165.96 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $66.07 Typical High $77.62 | Professional | 56 · Pre-op care only | $54.95 | $66.07 | $77.62 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $7,079.46 Typical High $10,232.93 | Facility | None | $831.76 | $7,079.46 | $10,232.93 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $1,148.15 Typical High $1,318.26 | Professional | None | $933.25 | $1,148.15 | $1,318.26 |
United Setting Facility Modifier None Typical Low $812.83 Median $2,630.27 Typical High $9,549.93 | Facility | None | $812.83 | $2,630.27 | $9,549.93 |
United Setting Professional Modifier None Typical Low $524.81 Median $724.44 Typical High $1,202.26 | Professional | None | $524.81 | $724.44 | $1,202.26 |
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 $416.87 Median $416.87 Typical High $416.87 | Professional | 52 · Reduced service | $416.87 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | 53 · Discontinued | $165.96 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $588.84 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $588.84 | $588.84 | $588.84 |
Where Rhode Island sits
The same service costs 5.4 times more in Alaska than in Montana. 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 $11,142MT $2,070
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.