How much rates vary
Facilitymedian $3,715 · 10th to 90th $955 to $10,233Professionalmedian $1,000 · 10th to 90th $759 to $1,413
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 $1,000.00 Median $1,000.00 Typical High $1,412.54 | Professional | None | $1,000.00 | $1,000.00 | $1,412.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $741.31 Typical High $741.31 | Professional | 54 · Surgery only | $741.31 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $147.91 Typical High $147.91 | Professional | 55 · Aftercare only | $147.91 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | 56 · Pre-op care only | $100.00 | $100.00 | $100.00 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $691.83 Median $912.01 Typical High $1,479.11 | Professional | None | $691.83 | $912.01 | $1,479.11 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $575.44 Typical High $933.25 | Professional | 54 · Surgery only | $407.38 | $575.44 | $933.25 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $109.65 Typical High $177.83 | Professional | 55 · Aftercare only | $77.62 | $109.65 | $177.83 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $93.33 Typical High $151.36 | Professional | 56 · Pre-op care only | $66.07 | $93.33 | $151.36 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $3,890.45 Typical High $5,495.41 | Facility | None | $954.99 | $3,890.45 | $5,495.41 |
Cigna Setting Professional Modifier None Typical Low $870.96 Median $1,318.26 Typical High $1,548.82 | Professional | None | $870.96 | $1,318.26 | $1,548.82 |
United Setting Facility Modifier None Typical Low $933.25 Median $3,548.13 Typical High $10,964.78 | Facility | None | $933.25 | $3,548.13 | $10,964.78 |
United Setting Professional Modifier None Typical Low $676.08 Median $1,000.00 Typical High $1,318.26 | Professional | None | $676.08 | $1,000.00 | $1,318.26 |
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 $501.19 Median $501.19 Typical High $501.19 | Professional | 52 · Reduced service | $501.19 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $199.53 Typical High $199.53 | Professional | 53 · Discontinued | $199.53 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $691.83 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $691.83 | $691.83 | $691.83 |
Where Rhode Island sits
The same service costs 4.5 times more in Alaska 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
AK $10,099MT $2,245
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.