How much rates vary
Facilitymedian $4,571 · 10th to 90th $1,023 to $15,488Professionalmedian $813 · 10th to 90th $562 to $1,096
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 $812.83 Median $812.83 Typical High $912.01 | Professional | None | $812.83 | $812.83 | $912.01 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $602.56 Typical High $602.56 | Professional | 54 · Surgery only | $602.56 | $602.56 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | 55 · Aftercare only | $120.23 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $81.28 Typical High $81.28 | Professional | 56 · Pre-op care only | $81.28 | $81.28 | $81.28 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $562.34 Median $741.31 Typical High $1,071.52 | Professional | None | $562.34 | $741.31 | $1,071.52 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $436.52 Typical High $512.86 | Professional | 54 · Surgery only | $354.81 | $436.52 | $512.86 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $131.83 Typical High $154.88 | Professional | 55 · Aftercare only | $109.65 | $131.83 | $154.88 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $63.10 Typical High $74.13 | Professional | 56 · Pre-op care only | $52.48 | $63.10 | $74.13 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $12,589.25 Typical High $17,782.79 | Facility | None | $831.76 | $12,589.25 | $17,782.79 |
Cigna Setting Professional Modifier None Typical Low $954.99 Median $1,071.52 Typical High $1,258.93 | Professional | None | $954.99 | $1,071.52 | $1,258.93 |
United Setting Facility Modifier None Typical Low $1,023.29 Median $4,570.88 Typical High $12,882.50 | Facility | None | $1,023.29 | $4,570.88 | $12,882.50 |
United Setting Professional Modifier None Typical Low $501.19 Median $724.44 Typical High $1,148.15 | Professional | None | $501.19 | $724.44 | $1,148.15 |
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 $407.38 Median $407.38 Typical High $407.38 | Professional | 52 · Reduced service | $407.38 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | 53 · Discontinued | $162.18 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $562.34 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $562.34 | $562.34 | $562.34 |
Where Rhode Island sits
The same service costs 10.1 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 $19,890MT $1,977
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.