How much rates vary
Facilitymedian $2,089 · 10th to 90th $871 to $5,888Professionalmedian $501 · 10th to 90th $407 to $794
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 $501.19 Median $501.19 Typical High $501.19 | Professional | None | $501.19 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $371.54 Typical High $371.54 | Professional | 54 · Surgery only | $371.54 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $74.13 Typical High $74.13 | Professional | 55 · Aftercare only | $74.13 | $74.13 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | 56 · Pre-op care only | $50.12 | $50.12 | $50.12 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $380.19 Median $501.19 Typical High $933.25 | Professional | None | $380.19 | $501.19 | $933.25 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $323.59 Typical High $602.56 | Professional | 54 · Surgery only | $229.09 | $323.59 | $602.56 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $60.26 Typical High $112.20 | Professional | 55 · Aftercare only | $41.69 | $60.26 | $112.20 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $42.66 Typical High $79.43 | Professional | 56 · Pre-op care only | $30.20 | $42.66 | $79.43 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $1,949.84 Typical High $2,754.23 | Facility | None | $588.84 | $1,949.84 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $549.54 Median $724.44 Typical High $912.01 | Professional | None | $549.54 | $724.44 | $912.01 |
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 $363.08 Median $489.78 Typical High $776.25 | Professional | None | $363.08 | $489.78 | $776.25 |
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 $251.19 Median $251.19 Typical High $251.19 | Professional | 52 · Reduced service | $251.19 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | 53 · Discontinued | $100.00 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $346.74 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $346.74 | $346.74 | $346.74 |
Where Rhode Island sits
The same service costs 4.1 times more in Oklahoma 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
OK $5,653MT $1,368
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.