How much rates vary
Facilitymedian $1,862 · 10th to 90th $871 to $5,888Professionalmedian $398 · 10th to 90th $302 to $562
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 $398.11 Median $398.11 Typical High $524.81 | Professional | None | $398.11 | $398.11 | $524.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $302.00 Typical High $302.00 | Professional | 54 · Surgery only | $302.00 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | 55 · Aftercare only | $60.26 | $60.26 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $39.81 Typical High $39.81 | Professional | 56 · Pre-op care only | $39.81 | $39.81 | $39.81 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $275.42 Median $363.08 Typical High $588.84 | Professional | None | $275.42 | $363.08 | $588.84 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $257.04 Typical High $416.87 | Professional | 54 · Surgery only | $181.97 | $257.04 | $416.87 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $28.18 Typical High $45.71 | Professional | 55 · Aftercare only | $19.50 | $28.18 | $45.71 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $25.12 Typical High $40.74 | Professional | 56 · Pre-op care only | $17.38 | $25.12 | $40.74 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $1,513.56 Typical High $1,862.09 | Facility | None | $831.76 | $1,513.56 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $407.38 Median $549.54 Typical High $616.60 | Professional | None | $407.38 | $549.54 | $616.60 |
United Setting Facility Modifier None Typical Low $870.96 Median $2,089.30 Typical High $5,888.44 | Facility | None | $870.96 | $2,089.30 | $5,888.44 |
United Setting Professional Modifier None Typical Low $263.03 Median $371.54 Typical High $512.86 | Professional | None | $263.03 | $371.54 | $512.86 |
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 $199.53 Median $199.53 Typical High $199.53 | Professional | 52 · Reduced service | $199.53 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $79.43 Typical High $79.43 | Professional | 53 · Discontinued | $79.43 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $281.84 Typical High $281.84 | Professional | 78 · Unplanned return to OR | $281.84 | $281.84 | $281.84 |
Where Rhode Island sits
The same service costs 6.6 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 $6,126MT $925
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.