How much rates vary
Facilitymedian $1,202 · 10th to 90th $372 to $6,457Professionalmedian $1,479 · 10th to 90th $1,148 to $1,995
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 $3,715.35 Median $3,715.35 Typical High $3,981.07 | Facility | None | $3,715.35 | $3,715.35 | $3,981.07 |
Aetna Setting Professional Modifier None Typical Low $1,318.26 Median $1,479.11 Typical High $1,479.11 | Professional | None | $1,318.26 | $1,479.11 | $1,479.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,122.02 Typical High $1,122.02 | Professional | 54 · Surgery only | $1,122.02 | $1,122.02 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $223.87 Typical High $223.87 | Professional | 55 · Aftercare only | $223.87 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $147.91 Typical High $147.91 | Professional | 56 · Pre-op care only | $147.91 | $147.91 | $147.91 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $1,380.38 Median $1,621.81 Typical High $1,621.81 | Professional | None | $1,380.38 | $1,621.81 | $1,621.81 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $1,096.48 Typical High $1,318.26 | Professional | 54 · Surgery only | $776.25 | $1,096.48 | $1,318.26 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $138.04 Typical High $162.18 | Professional | 55 · Aftercare only | $95.50 | $138.04 | $162.18 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $123.03 Typical High $144.54 | Professional | 56 · Pre-op care only | $87.10 | $123.03 | $144.54 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $676.08 Typical High $1,202.26 | Facility | None | $50.12 | $676.08 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $1,949.84 Median $1,995.26 Typical High $1,995.26 | Professional | None | $1,949.84 | $1,995.26 | $1,995.26 |
United Setting Facility Modifier None Typical Low $426.58 Median $1,513.56 Typical High $6,456.54 | Facility | None | $426.58 | $1,513.56 | $6,456.54 |
United Setting Professional Modifier None Typical Low $1,047.13 Median $1,174.90 Typical High $1,778.28 | Professional | None | $1,047.13 | $1,174.90 | $1,778.28 |
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 $741.31 Median $741.31 Typical High $741.31 | Professional | 52 · Reduced service | $741.31 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $295.12 Typical High $295.12 | Professional | 53 · Discontinued | $295.12 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,047.13 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,047.13 | $1,047.13 |
Where Rhode Island sits
The same service costs 5.9 times more in Alabama than in Maryland. 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 $10,682MD $1,821
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.