How much rates vary
Facilitymedian $2,630 · 10th to 90th $813 to $7,244Professionalmedian $891 · 10th to 90th $589 to $1,175
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 $870.96 Median $891.25 Typical High $891.25 | Professional | None | $870.96 | $891.25 | $891.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $660.69 Typical High $660.69 | Professional | 54 · Surgery only | $660.69 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $131.83 Typical High $131.83 | Professional | 55 · Aftercare only | $131.83 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $89.13 Typical High $89.13 | Professional | 56 · Pre-op care only | $89.13 | $89.13 | $89.13 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $588.84 Median $794.33 Typical High $1,148.15 | Professional | None | $588.84 | $794.33 | $1,148.15 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $467.74 Typical High $549.54 | Professional | 54 · Surgery only | $380.19 | $467.74 | $549.54 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $141.25 Typical High $165.96 | Professional | 55 · Aftercare only | $117.49 | $141.25 | $165.96 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $67.61 Typical High $79.43 | Professional | 56 · Pre-op care only | $54.95 | $67.61 | $79.43 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $2,137.96 Typical High $3,090.30 | Facility | None | $588.84 | $2,137.96 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $1,047.13 Median $1,148.15 Typical High $1,348.96 | Professional | None | $1,047.13 | $1,148.15 | $1,348.96 |
United Setting Facility Modifier None Typical Low $812.83 Median $2,630.27 Typical High $7,762.47 | Facility | None | $812.83 | $2,630.27 | $7,762.47 |
United Setting Professional Modifier None Typical Low $549.54 Median $794.33 Typical High $1,230.27 | Professional | None | $549.54 | $794.33 | $1,230.27 |
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 $446.68 Median $446.68 Typical High $446.68 | Professional | 52 · Reduced service | $446.68 | $446.68 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $177.83 Typical High $177.83 | Professional | 53 · Discontinued | $177.83 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $616.60 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $616.60 | $616.60 | $616.60 |
Where Rhode Island sits
The same service costs 3.5 times more in Wisconsin than in Hawaii. 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
WI $7,283HI $2,091
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.