How much rates vary
Facilitymedian $3,802 · 10th to 90th $955 to $10,233Professionalmedian $1,259 · 10th to 90th $933 to $1,698
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 $3,467.37 Median $3,715.35 Typical High $3,981.07 | Facility | None | $3,467.37 | $3,715.35 | $3,981.07 |
Aetna Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,258.93 | Professional | None | $1,258.93 | $1,258.93 | $1,258.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $954.99 Typical High $954.99 | Professional | 54 · Surgery only | $954.99 | $954.99 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $190.55 Typical High $190.55 | Professional | 55 · Aftercare only | $190.55 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | 56 · Pre-op care only | $125.89 | $125.89 | $125.89 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $851.14 Median $1,122.02 Typical High $1,905.46 | Professional | None | $851.14 | $1,122.02 | $1,905.46 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $794.33 Typical High $1,318.26 | Professional | 54 · Surgery only | $562.34 | $794.33 | $1,318.26 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $87.10 Typical High $144.54 | Professional | 55 · Aftercare only | $60.26 | $87.10 | $144.54 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $75.86 Typical High $128.82 | Professional | 56 · Pre-op care only | $53.70 | $75.86 | $128.82 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $6,606.93 Typical High $9,549.93 | Facility | None | $954.99 | $6,606.93 | $9,549.93 |
Cigna Setting Professional Modifier None Typical Low $1,230.27 Median $1,698.24 Typical High $1,949.84 | Professional | None | $1,230.27 | $1,698.24 | $1,949.84 |
United Setting Facility Modifier None Typical Low $933.25 Median $3,548.13 Typical High $12,589.25 | Facility | None | $933.25 | $3,548.13 | $12,589.25 |
United Setting Professional Modifier None Typical Low $831.76 Median $1,174.90 Typical High $1,621.81 | Professional | None | $831.76 | $1,174.90 | $1,621.81 |
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 $630.96 Median $630.96 Typical High $630.96 | Professional | 52 · Reduced service | $630.96 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $251.19 Typical High $251.19 | Professional | 53 · Discontinued | $251.19 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $891.25 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $891.25 | $891.25 | $891.25 |
Where Rhode Island sits
The same service costs 4.6 times more in Wyoming 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
WY $13,103MT $2,825
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.