How much rates vary
Facilitymedian $2,818 · 10th to 90th $832 to $7,762Professionalmedian $724 · 10th to 90th $562 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 $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 $724.44 Median $724.44 Typical High $724.44 | Professional | None | $724.44 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $537.03 Typical High $537.03 | Professional | 54 · Surgery only | $537.03 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $107.15 Typical High $107.15 | Professional | 55 · Aftercare only | $107.15 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $72.44 Typical High $72.44 | Professional | 56 · Pre-op care only | $72.44 | $72.44 | $72.44 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $676.08 Median $794.33 Typical High $794.33 | Professional | None | $676.08 | $794.33 | $794.33 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $549.54 Typical High $645.65 | Professional | 54 · Surgery only | $389.05 | $549.54 | $645.65 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $67.61 Typical High $79.43 | Professional | 55 · Aftercare only | $47.86 | $67.61 | $79.43 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $61.66 Typical High $72.44 | Professional | 56 · Pre-op care only | $42.66 | $61.66 | $72.44 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $2,290.87 Typical High $3,235.94 | Facility | None | $831.76 | $2,290.87 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $954.99 Median $977.24 Typical High $977.24 | Professional | None | $954.99 | $977.24 | $977.24 |
United Setting Facility Modifier None Typical Low $812.83 Median $2,630.27 Typical High $7,943.28 | Facility | None | $812.83 | $2,630.27 | $7,943.28 |
United Setting Professional Modifier None Typical Low $537.03 Median $588.84 Typical High $870.96 | Professional | None | $537.03 | $588.84 | $870.96 |
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 $363.08 Median $363.08 Typical High $363.08 | Professional | 52 · Reduced service | $363.08 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | 53 · Discontinued | $144.54 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $501.19 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $501.19 | $501.19 | $501.19 |
Where Rhode Island sits
The same service costs 4.0 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 $7,771MT $1,932
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.