How much rates vary
Facilitymedian $2,754 · 10th to 90th $871 to $6,918Professionalmedian $631 · 10th to 90th $380 to $977
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 $2,398.83 Median $3,235.94 Typical High $3,981.07 | Facility | None | $2,398.83 | $3,235.94 | $3,981.07 |
Aetna Setting Professional Modifier None Typical Low $467.74 Median $537.03 Typical High $691.83 | Professional | None | $467.74 | $537.03 | $691.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $398.11 Typical High $512.86 | Professional | 54 · Surgery only | $346.74 | $398.11 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $79.43 Typical High $102.33 | Professional | 55 · Aftercare only | $69.18 | $79.43 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $53.70 Typical High $69.18 | Professional | 56 · Pre-op care only | $46.77 | $53.70 | $69.18 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $380.19 Median $537.03 Typical High $776.25 | Professional | None | $380.19 | $537.03 | $776.25 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $316.23 Typical High $457.09 | Professional | 54 · Surgery only | $213.80 | $316.23 | $457.09 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $97.72 Typical High $138.04 | Professional | 55 · Aftercare only | $64.57 | $97.72 | $138.04 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $45.71 Typical High $66.07 | Professional | 56 · Pre-op care only | $30.90 | $45.71 | $66.07 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $4,786.30 Typical High $6,918.31 | Facility | None | $676.08 | $4,786.30 | $6,918.31 |
Cigna Setting Professional Modifier None Typical Low $645.65 Median $741.31 Typical High $977.24 | Professional | None | $645.65 | $741.31 | $977.24 |
United Setting Facility Modifier None Typical Low $870.96 Median $2,089.30 Typical High $7,413.10 | Facility | None | $870.96 | $2,089.30 | $7,413.10 |
United Setting Professional Modifier None Typical Low $309.03 Median $489.78 Typical High $891.25 | Professional | None | $309.03 | $489.78 | $891.25 |
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 $234.42 Median $269.15 Typical High $346.74 | Professional | 52 · Reduced service | $234.42 | $269.15 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $107.15 Typical High $138.04 | Professional | 53 · Discontinued | $93.33 | $107.15 | $138.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $371.54 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $323.59 | $371.54 | $478.63 |
Where Rhode Island sits
The same service costs 6.4 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 $8,723MT $1,361
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.