How much rates vary
Facilitymedian $2,754 · 10th to 90th $871 to $5,888Professionalmedian $1,622 · 10th to 90th $1,148 to $2,089
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 $2,398.83 Median $3,235.94 Typical High $3,981.07 | Facility | None | $2,398.83 | $3,235.94 | $3,981.07 |
Aetna Setting Professional Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $1,621.81 | Professional | None | $1,621.81 | $1,621.81 | $1,621.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Professional | 54 · Surgery only | $1,230.27 | $1,230.27 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $245.47 Median $245.47 Typical High $245.47 | Professional | 55 · Aftercare only | $245.47 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | 56 · Pre-op care only | $162.18 | $162.18 | $162.18 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $1,096.48 Median $1,445.44 Typical High $2,344.23 | Professional | None | $1,096.48 | $1,445.44 | $2,344.23 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $912.01 Typical High $1,479.11 | Professional | 54 · Surgery only | $630.96 | $912.01 | $1,479.11 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $173.78 Typical High $281.84 | Professional | 55 · Aftercare only | $120.23 | $173.78 | $281.84 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $147.91 Typical High $239.88 | Professional | 56 · Pre-op care only | $102.33 | $147.91 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $3,019.95 Typical High $4,265.80 | Facility | None | $676.08 | $3,019.95 | $4,265.80 |
Cigna Setting Professional Modifier None Typical Low $1,348.96 Median $2,089.30 Typical High $2,511.89 | Professional | None | $1,348.96 | $2,089.30 | $2,511.89 |
United Setting Facility Modifier None Typical Low $870.96 Median $2,089.30 Typical High $7,413.10 | Facility | None | $870.96 | $2,089.30 | $7,413.10 |
United Setting Professional Modifier None Typical Low $1,000.00 Median $1,445.44 Typical High $2,089.30 | Professional | None | $1,000.00 | $1,445.44 | $2,089.30 |
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 $812.83 Median $812.83 Typical High $812.83 | Professional | 52 · Reduced service | $812.83 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $323.59 Median $323.59 Typical High $323.59 | Professional | 53 · Discontinued | $323.59 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,148.15 Median $1,148.15 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $1,148.15 | $1,148.15 | $1,148.15 |
Where Rhode Island sits
The same service costs 4.4 times more in Alaska than in Kentucky. 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 $10,675KY $2,405
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.