How much rates vary
Facilitymedian $3,162 · 10th to 90th $813 to $12,589Professionalmedian $1,514 · 10th to 90th $955 to $2,042
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 $1,513.56 Median $1,513.56 Typical High $1,513.56 | Professional | None | $1,513.56 | $1,513.56 | $1,513.56 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,148.15 Typical High $1,148.15 | Professional | 54 · Surgery only | $1,148.15 | $1,148.15 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | 55 · Aftercare only | $229.09 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | 56 · Pre-op care only | $151.36 | $151.36 | $151.36 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $1,023.29 Median $1,348.96 Typical High $1,995.26 | Professional | None | $1,023.29 | $1,348.96 | $1,995.26 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $794.33 Typical High $933.25 | Professional | 54 · Surgery only | $660.69 | $794.33 | $933.25 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $245.47 Typical High $288.40 | Professional | 55 · Aftercare only | $199.53 | $245.47 | $288.40 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $114.82 Typical High $134.90 | Professional | 56 · Pre-op care only | $95.50 | $114.82 | $134.90 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $11,481.54 Typical High $16,595.87 | Facility | None | $588.84 | $11,481.54 | $16,595.87 |
Cigna Setting Professional Modifier None Typical Low $1,513.56 Median $2,041.74 Typical High $2,344.23 | Professional | None | $1,513.56 | $2,041.74 | $2,344.23 |
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 $851.14 Median $1,148.15 Typical High $2,187.76 | Professional | None | $851.14 | $1,148.15 | $2,187.76 |
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 $758.58 Median $758.58 Typical High $758.58 | Professional | 52 · Reduced service | $758.58 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $302.00 Typical High $302.00 | Professional | 53 · Discontinued | $302.00 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,071.52 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,071.52 | $1,071.52 |
Where Rhode Island sits
The same service costs 6.9 times more in Alaska 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
AK $18,481HI $2,671
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.