How much rates vary
Facilitymedian $316 · 10th to 90th $112 to $3,890Professionalmedian $389 · 10th to 90th $324 to $589
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 $331.13 Median $363.08 Typical High $363.08 | Professional | None | $331.13 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $269.15 Typical High $275.42 | Professional | 54 · Surgery only | $245.47 | $269.15 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $53.70 Typical High $54.95 | Professional | 55 · Aftercare only | $48.98 | $53.70 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $36.31 Typical High $36.31 | Professional | 56 · Pre-op care only | $33.11 | $36.31 | $36.31 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $331.13 Median $398.11 Typical High $562.34 | Professional | None | $331.13 | $398.11 | $562.34 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $269.15 Typical High $338.84 | Professional | 54 · Surgery only | $190.55 | $269.15 | $338.84 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $77.62 Typical High $97.72 | Professional | 55 · Aftercare only | $53.70 | $77.62 | $97.72 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $38.90 Typical High $48.98 | Professional | 56 · Pre-op care only | $26.92 | $38.90 | $48.98 |
Cigna Setting Facility Modifier None Typical Low $208.93 Median $269.15 Typical High $1,202.26 | Facility | None | $208.93 | $269.15 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $575.44 Typical High $588.84 | Professional | None | $331.13 | $575.44 | $588.84 |
United Setting Facility Modifier None Typical Low $97.72 Median $316.23 Typical High $3,890.45 | Facility | None | $97.72 | $316.23 | $3,890.45 |
United Setting Professional Modifier None Typical Low $263.03 Median $389.05 Typical High $512.86 | Professional | None | $263.03 | $389.05 | $512.86 |
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 $165.96 Median $177.83 Typical High $181.97 | Professional | 52 · Reduced service | $165.96 | $177.83 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $72.44 Typical High $72.44 | Professional | 53 · Discontinued | $66.07 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $251.19 Typical High $257.04 | Professional | 78 · Unplanned return to OR | $229.09 | $251.19 | $257.04 |
Where Rhode Island sits
The same service costs 7.4 times more in Hawaii than in Florida. 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
HI $3,255FL $440
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.