How much rates vary
Facilitymedian $3,802 · 10th to 90th $1,230 to $10,233Professionalmedian $1,698 · 10th to 90th $1,259 to $2,455
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 $5,495.41 | Facility | None | $3,715.35 | $3,981.07 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $1,698.24 | Professional | None | $1,698.24 | $1,698.24 | $1,698.24 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,258.93 Median $1,258.93 Typical High $1,258.93 | Professional | 54 · Surgery only | $1,258.93 | $1,258.93 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $251.19 Median $251.19 Typical High $251.19 | Professional | 55 · Aftercare only | $251.19 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $169.82 Median $169.82 Typical High $169.82 | Professional | 56 · Pre-op care only | $169.82 | $169.82 | $169.82 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $1,258.93 Median $1,659.59 Typical High $2,754.23 | Professional | None | $1,258.93 | $1,659.59 | $2,754.23 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $1,122.02 Typical High $1,862.09 | Professional | 54 · Surgery only | $794.33 | $1,122.02 | $1,862.09 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $199.53 Typical High $331.13 | Professional | 55 · Aftercare only | $138.04 | $199.53 | $331.13 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $100.00 Typical High $165.96 | Professional | 56 · Pre-op care only | $69.18 | $100.00 | $165.96 |
Cigna Setting Facility Modifier None Typical Low $1,318.26 Median $3,981.07 Typical High $5,623.41 | Facility | None | $1,318.26 | $3,981.07 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $1,819.70 Median $2,398.83 Typical High $2,884.03 | Professional | None | $1,819.70 | $2,398.83 | $2,884.03 |
United Setting Facility Modifier None Typical Low $933.25 Median $3,548.13 Typical High $12,589.25 | Facility | None | $933.25 | $3,548.13 | $12,589.25 |
United Setting Professional Modifier None Typical Low $1,202.26 Median $1,513.56 Typical High $2,454.71 | Professional | None | $1,202.26 | $1,513.56 | $2,454.71 |
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 $831.76 Median $831.76 Typical High $831.76 | Professional | 52 · Reduced service | $831.76 | $831.76 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $338.84 Median $338.84 Typical High $338.84 | Professional | 53 · Discontinued | $338.84 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,174.90 Median $1,174.90 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $1,174.90 | $1,174.90 | $1,174.90 |
Where Rhode Island sits
The same service costs 3.0 times more in Alaska than in Vermont. 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 $12,999VT $4,294
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.