How much rates vary
Facilitymedian $4,571 · 10th to 90th $891 to $13,804Professionalmedian $562 · 10th to 90th $191 to $4,677
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 $1,513.56 Median $1,548.82 Typical High $3,981.07 | Facility | None | $1,513.56 | $1,548.82 | $3,981.07 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $251.19 Typical High $251.19 | Professional | None | $190.55 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $186.21 Typical High $186.21 | Professional | 54 · Surgery only | $144.54 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $37.15 Typical High $37.15 | Professional | 55 · Aftercare only | $28.84 | $37.15 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $25.12 Typical High $25.12 | Professional | 56 · Pre-op care only | $19.05 | $25.12 | $25.12 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $398.11 Median $562.34 Typical High $4,677.35 | Professional | None | $398.11 | $562.34 | $4,677.35 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $446.68 Typical High $3,715.35 | Professional | 54 · Surgery only | $309.03 | $446.68 | $3,715.35 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $56.23 Typical High $467.74 | Professional | 55 · Aftercare only | $38.90 | $56.23 | $467.74 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $56.23 Typical High $467.74 | Professional | 56 · Pre-op care only | $38.90 | $56.23 | $467.74 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $11,220.18 Typical High $16,218.10 | Facility | None | $446.68 | $11,220.18 | $16,218.10 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $758.58 Typical High $4,466.84 | Professional | None | $562.34 | $758.58 | $4,466.84 |
United Setting Facility Modifier None Typical Low $1,023.29 Median $4,570.88 Typical High $12,882.50 | Facility | None | $1,023.29 | $4,570.88 | $12,882.50 |
United Setting Professional Modifier None Typical Low $181.97 Median $371.54 Typical High $2,951.21 | Professional | None | $181.97 | $371.54 | $2,951.21 |
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 $95.50 Median $123.03 Typical High $123.03 | Professional | 52 · Reduced service | $95.50 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $50.12 Typical High $50.12 | Professional | 53 · Discontinued | $38.02 | $50.12 | $50.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $134.90 Median $173.78 Typical High $173.78 | Professional | 78 · Unplanned return to OR | $134.90 | $173.78 | $173.78 |
Where Rhode Island sits
The same service costs 18.4 times more in Alabama 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
AL $30,876MT $1,679
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.