How much rates vary
Facilitymedian $2,692 · 10th to 90th $955 to $5,888Professionalmedian $724 · 10th to 90th $550 to $1,047
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 $691.83 Median $691.83 Typical High $1,000.00 | Professional | None | $691.83 | $691.83 | $1,000.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $524.81 Typical High $524.81 | Professional | 54 · Surgery only | $524.81 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $104.71 Typical High $104.71 | Professional | 55 · Aftercare only | $104.71 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $69.18 Typical High $69.18 | Professional | 56 · Pre-op care only | $69.18 | $69.18 | $69.18 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $549.54 Median $724.44 Typical High $1,071.52 | Professional | None | $549.54 | $724.44 | $1,071.52 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $457.09 Typical High $676.08 | Professional | 54 · Surgery only | $323.59 | $457.09 | $676.08 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $87.10 Typical High $125.89 | Professional | 55 · Aftercare only | $60.26 | $87.10 | $125.89 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $74.13 Typical High $109.65 | Professional | 56 · Pre-op care only | $52.48 | $74.13 | $109.65 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $2,238.72 Typical High $3,235.94 | Facility | None | $954.99 | $2,238.72 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $1,047.13 Typical High $1,174.90 | Professional | None | $691.83 | $1,047.13 | $1,174.90 |
United Setting Facility Modifier None Typical Low $870.96 Median $2,089.30 Typical High $7,079.46 | Facility | None | $870.96 | $2,089.30 | $7,079.46 |
United Setting Professional Modifier None Typical Low $501.19 Median $645.65 Typical High $977.24 | Professional | None | $501.19 | $645.65 | $977.24 |
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 $346.74 Median $346.74 Typical High $346.74 | Professional | 52 · Reduced service | $346.74 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $141.25 Typical High $141.25 | Professional | 53 · Discontinued | $141.25 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $489.78 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $489.78 | $489.78 | $489.78 |
Where Rhode Island sits
The same service costs 3.6 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 $6,446MT $1,806
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.