How much rates vary
Facilitymedian $2,399 · 10th to 90th $871 to $5,888Professionalmedian $676 · 10th to 90th $398 to $1,023
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 $512.86 Median $645.65 Typical High $724.44 | Professional | None | $512.86 | $645.65 | $724.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $446.68 Typical High $549.54 | Professional | 54 · Surgery only | $389.05 | $446.68 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $89.13 Typical High $109.65 | Professional | 55 · Aftercare only | $77.62 | $89.13 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $58.88 Typical High $72.44 | Professional | 56 · Pre-op care only | $51.29 | $58.88 | $72.44 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $416.87 Median $575.44 Typical High $851.14 | Professional | None | $416.87 | $575.44 | $851.14 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $338.84 Typical High $467.74 | Professional | 54 · Surgery only | $234.42 | $338.84 | $467.74 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $102.33 Typical High $141.25 | Professional | 55 · Aftercare only | $72.44 | $102.33 | $141.25 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $48.98 Typical High $67.61 | Professional | 56 · Pre-op care only | $33.88 | $48.98 | $67.61 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $2,137.96 Typical High $3,090.30 | Facility | None | $676.08 | $2,137.96 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $645.65 Median $758.58 Typical High $1,023.29 | Professional | None | $645.65 | $758.58 | $1,023.29 |
United Setting Facility Modifier None Typical Low $870.96 Median $2,089.30 Typical High $7,244.36 | Facility | None | $870.96 | $2,089.30 | $7,244.36 |
United Setting Professional Modifier None Typical Low $323.59 Median $501.19 Typical High $933.25 | Professional | None | $323.59 | $501.19 | $933.25 |
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 $257.04 Median $295.12 Typical High $363.08 | Professional | 52 · Reduced service | $257.04 | $295.12 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $117.49 Typical High $144.54 | Professional | 53 · Discontinued | $102.33 | $117.49 | $144.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $416.87 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $363.08 | $416.87 | $512.86 |
Where Rhode Island sits
The same service costs 5.8 times more in Alabama 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
AL $8,423MT $1,458
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.