How much rates vary
Facilitymedian $1,413 · 10th to 90th $646 to $4,898Professionalmedian $1,023 · 10th to 90th $676 to $1,349
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 $2,089.30 Median $2,754.23 Typical High $3,981.07 | Facility | None | $2,089.30 | $2,754.23 | $3,981.07 |
Aetna Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,023.29 | Professional | None | $1,023.29 | $1,023.29 | $1,023.29 |
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 $154.88 Median $154.88 Typical High $154.88 | Professional | 55 · Aftercare only | $154.88 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $102.33 Typical High $102.33 | Professional | 56 · Pre-op care only | $102.33 | $102.33 | $102.33 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $676.08 Median $912.01 Typical High $1,318.26 | Professional | None | $676.08 | $912.01 | $1,318.26 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $537.03 Typical High $630.96 | Professional | 54 · Surgery only | $436.52 | $537.03 | $630.96 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $162.18 Typical High $190.55 | Professional | 55 · Aftercare only | $131.83 | $162.18 | $190.55 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $77.62 Typical High $91.20 | Professional | 56 · Pre-op care only | $63.10 | $77.62 | $91.20 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $1,148.15 Typical High $1,621.81 | Facility | None | $588.84 | $1,148.15 | $1,621.81 |
Cigna Setting Professional Modifier None Typical Low $1,122.02 Median $1,348.96 Typical High $1,548.82 | Professional | None | $1,122.02 | $1,348.96 | $1,548.82 |
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 $630.96 Median $891.25 Typical High $1,412.54 | Professional | None | $630.96 | $891.25 | $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 $512.86 Median $512.86 Typical High $512.86 | Professional | 52 · Reduced service | $512.86 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $204.17 Typical High $204.17 | Professional | 53 · Discontinued | $204.17 | $204.17 | $204.17 |
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 3.6 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 $5,545AL $1,558
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.