How much rates vary
Facilitymedian $3,981 · 10th to 90th $933 to $10,233Professionalmedian $813 · 10th to 90th $708 to $1,230
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 $3,715.35 Median $3,981.07 Typical High $4,897.79 | Facility | None | $3,715.35 | $3,981.07 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $707.95 Median $794.33 Typical High $794.33 | Professional | None | $707.95 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $588.84 Typical High $588.84 | Professional | 54 · Surgery only | $524.81 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $117.49 Typical High $117.49 | Professional | 55 · Aftercare only | $104.71 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $79.43 Typical High $79.43 | Professional | 56 · Pre-op care only | $70.79 | $79.43 | $79.43 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $691.83 Median $812.83 Typical High $1,148.15 | Professional | None | $691.83 | $812.83 | $1,148.15 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $562.34 Typical High $707.95 | Professional | 54 · Surgery only | $398.11 | $562.34 | $707.95 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $162.18 Typical High $204.17 | Professional | 55 · Aftercare only | $112.20 | $162.18 | $204.17 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $81.28 Typical High $102.33 | Professional | 56 · Pre-op care only | $56.23 | $81.28 | $102.33 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $5,248.07 Typical High $7,413.10 | Facility | None | $676.08 | $5,248.07 | $7,413.10 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $1,230.27 Typical High $1,230.27 | Professional | None | $776.25 | $1,230.27 | $1,230.27 |
United Setting Facility Modifier None Typical Low $933.25 Median $3,548.13 Typical High $11,748.98 | Facility | None | $933.25 | $3,548.13 | $11,748.98 |
United Setting Professional Modifier None Typical Low $660.69 Median $776.25 Typical High $1,174.90 | Professional | None | $660.69 | $776.25 | $1,174.90 |
2 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 $354.81 Median $398.11 Typical High $398.11 | Professional | 52 · Reduced service | $354.81 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $158.49 Typical High $158.49 | Professional | 53 · Discontinued | $141.25 | $158.49 | $158.49 |
Where Rhode Island sits
The same service costs 5.9 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 $12,304MT $2,095
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.