How much rates vary
Facilitymedian $6,310 · 10th to 90th $1,479 to $35,481Professionalmedian $490 · 10th to 90th $347 to $724
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 $2,089.30 Median $2,754.23 Typical High $3,981.07 | Facility | None | $2,089.30 | $2,754.23 | $3,981.07 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $489.78 | Professional | None | $489.78 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $363.08 Typical High $363.08 | Professional | 54 · Surgery only | $363.08 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $72.44 Typical High $72.44 | Professional | 55 · Aftercare only | $72.44 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $48.98 Typical High $48.98 | Professional | 56 · Pre-op care only | $48.98 | $48.98 | $48.98 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $363.08 Median $478.63 Typical High $741.31 | Professional | None | $363.08 | $478.63 | $741.31 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $323.59 Typical High $380.19 | Professional | 54 · Surgery only | $269.15 | $323.59 | $380.19 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $40.74 Typical High $47.86 | Professional | 55 · Aftercare only | $33.88 | $40.74 | $47.86 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $40.74 Typical High $47.86 | Professional | 56 · Pre-op care only | $33.88 | $40.74 | $47.86 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $19,952.62 Typical High $28,840.32 | Facility | None | $588.84 | $19,952.62 | $28,840.32 |
Cigna Setting Professional Modifier None Typical Low $645.65 Median $660.69 Typical High $794.33 | Professional | None | $645.65 | $660.69 | $794.33 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $6,309.57 Typical High $39,810.72 | Facility | None | $1,698.24 | $6,309.57 | $39,810.72 |
United Setting Professional Modifier None Typical Low $316.23 Median $489.78 Typical High $724.44 | Professional | None | $316.23 | $489.78 | $724.44 |
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 $245.47 Median $245.47 Typical High $245.47 | Professional | 52 · Reduced service | $245.47 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $97.72 Typical High $97.72 | Professional | 53 · Discontinued | $97.72 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $338.84 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $338.84 | $338.84 | $338.84 |
Where Rhode Island sits
The same service costs 29.4 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 $37,066MT $1,262
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.