How much rates vary
Facilitymedian $1,862 · 10th to 90th $871 to $5,888Professionalmedian $912 · 10th to 90th $661 to $1,318
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 $870.96 Median $870.96 Typical High $954.99 | Professional | None | $870.96 | $870.96 | $954.99 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $660.69 Typical High $660.69 | Professional | 54 · Surgery only | $660.69 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $131.83 Typical High $131.83 | Professional | 55 · Aftercare only | $131.83 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $87.10 Typical High $87.10 | Professional | 56 · Pre-op care only | $87.10 | $87.10 | $87.10 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $676.08 Median $912.01 Typical High $1,412.54 | Professional | None | $676.08 | $912.01 | $1,412.54 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $588.84 Typical High $691.83 | Professional | 54 · Surgery only | $478.63 | $588.84 | $691.83 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $100.00 Typical High $117.49 | Professional | 55 · Aftercare only | $83.18 | $100.00 | $117.49 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $85.11 Typical High $100.00 | Professional | 56 · Pre-op care only | $70.79 | $85.11 | $100.00 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $1,318.26 Typical High $1,778.28 | Facility | None | $676.08 | $1,318.26 | $1,778.28 |
Cigna Setting Professional Modifier None Typical Low $1,047.13 Median $1,258.93 Typical High $1,513.56 | Professional | None | $1,047.13 | $1,258.93 | $1,513.56 |
United Setting Facility Modifier None Typical Low $870.96 Median $2,089.30 Typical High $5,888.44 | Facility | None | $870.96 | $2,089.30 | $5,888.44 |
United Setting Professional Modifier None Typical Low $602.56 Median $776.25 Typical High $1,348.96 | Professional | None | $602.56 | $776.25 | $1,348.96 |
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 $436.52 Median $436.52 Typical High $436.52 | Professional | 52 · Reduced service | $436.52 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | 53 · Discontinued | $173.78 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $616.60 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $616.60 | $616.60 | $616.60 |
Where Rhode Island sits
The same service costs 3.0 times more in Alaska than in Maryland. 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 $5,643MD $1,856
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.